EOS Inoovation Photo's

International Nuclear Information System (INIS)

2011-01-01

What did four years of energy innovation bring the Netherlands? Which are the main lessons learned and what are the best opportunities for the market? The Energy Research Strategy programme (EOS) gave the answers to these questions for various topics in the form of images by means of so-called I nnovation Photos' on Biomass, Built Environment, Industrial Energy Efficiency, Smart Grids, Heat, Offshore Wind, and Solar PV. [nl

EO-1 analysis applicable to coastal characterization

Science.gov (United States)

Burke, Hsiao-hua K.; Misra, Bijoy; Hsu, Su May; Griffin, Michael K.; Upham, Carolyn; Farrar, Kris

2003-09-01

The EO-1 satellite is part of NASA's New Millennium Program (NMP). It consists of three imaging sensors: the multi-spectral Advanced Land Imager (ALI), Hyperion and Atmospheric Corrector. Hyperion provides a high-resolution hyperspectral imager capable of resolving 220 spectral bands (from 0.4 to 2.5 micron) with a 30 m resolution. The instrument images a 7.5 km by 100 km land area per image. Hyperion is currently the only space-borne HSI data source since the launch of EO-1 in late 2000. The discussion begins with the unique capability of hyperspectral sensing to coastal characterization: (1) most ocean feature algorithms are semi-empirical retrievals and HSI has all spectral bands to provide legacy with previous sensors and to explore new information, (2) coastal features are more complex than those of deep ocean that coupled effects are best resolved with HSI, and (3) with contiguous spectral coverage, atmospheric compensation can be done with more accuracy and confidence, especially since atmospheric aerosol effects are the most pronounced in the visible region where coastal feature lie. EO-1 data from Chesapeake Bay from 19 February 2002 are analyzed. In this presentation, it is first illustrated that hyperspectral data inherently provide more information for feature extraction than multispectral data despite Hyperion has lower SNR than ALI. Chlorophyll retrievals are also shown. The results compare favorably with data from other sources. The analysis illustrates the potential value of Hyperion (and HSI in general) data to coastal characterization. Future measurement requirements (air borne and space borne) are also discussed.

Computed Tomography Imaging of a Hip Prosthesis Using Iterative Model-Based Reconstruction and Orthopaedic Metal Artefact Reduction: A Quantitative Analysis.

Science.gov (United States)

Wellenberg, Ruud H H; Boomsma, Martijn F; van Osch, Jochen A C; Vlassenbroek, Alain; Milles, Julien; Edens, Mireille A; Streekstra, Geert J; Slump, Cornelis H; Maas, Mario

To quantify the combined use of iterative model-based reconstruction (IMR) and orthopaedic metal artefact reduction (O-MAR) in reducing metal artefacts and improving image quality in a total hip arthroplasty phantom. Scans acquired at several dose levels and kVps were reconstructed with filtered back-projection (FBP), iterative reconstruction (iDose) and IMR, with and without O-MAR. Computed tomography (CT) numbers, noise levels, signal-to-noise-ratios and contrast-to-noise-ratios were analysed. Iterative model-based reconstruction results in overall improved image quality compared to iDose and FBP (P < 0.001). Orthopaedic metal artefact reduction is most effective in reducing severe metal artefacts improving CT number accuracy by 50%, 60%, and 63% (P < 0.05) and reducing noise by 1%, 62%, and 85% (P < 0.001) whereas improving signal-to-noise-ratios by 27%, 47%, and 46% (P < 0.001) and contrast-to-noise-ratios by 16%, 25%, and 19% (P < 0.001) with FBP, iDose, and IMR, respectively. The combined use of IMR and O-MAR strongly improves overall image quality and strongly reduces metal artefacts in the CT imaging of a total hip arthroplasty phantom.

What We Have Learned with 16 Years of EO-1 Hyperion

Science.gov (United States)

Ungar, S.

2016-12-01

The Earth Observing-One (EO-1) satellite, launched in November of 2000, will complete its sixteenth and final year of operation at the end of calendar year 2016. Observations from the Hyperion Imaging Spectrometer on board EO-1 have contributed to hundreds of papers in refereed journals, conference proceeds and other presentations. The EO-1 Hyperion imaging spectrometer is the first and longest operating instrument that provides visible to shortwave infrared science-grade data from orbit. Hyperion has been used to study a variety of natural and anthropogenic phenomena including hazards and catastrophes, agricultural health and productivity, ecological disturbance/development, and land use/land cover change. As an example, Hyperion has been used in hazard and catastrophe studies to monitor and assess effects of tsunamis, earthquakes, volcanic eruptions, mudslides, tornadoes, hurricanes, wild-fires (natural and human ignited), oil spills, and the aftermath of world trade center bombing. This presentation summarizes the current status of EO-1 Hyperion in terms of key scientific findings to date and presents future plans for exploiting the upward of 90,000 scenes expected to be archived at USGS EROS by the end of the mission. Hyperion serves as the heritage orbital spectrometer for future global platforms, including the proposed NASA Hyperspectral Infrared Imager (HyspIRI) and the forthcoming German satellite, EnMAP. A key EO-1 mission goal was to evaluate the ability of satellite high spectral resolution imaging to characterize terrestrial surface state and processes at 30 m resolution. Researchers engaged in NASA's Terrestrial Ecology, Carbon Science, Land Use Change and other programs using the EO-1 Hyperion imaging spectrometer have achieved results with accuracies far exceeding those reached with the current spaceborne fleet of multispectral sensors. Hyperion data provide several advantages over data from multispectral satellite systems: they inherently provide

SU-E-I-15: Comparison of Radiation Dose for Radiography and EOS in Adolescent Scoliosis Patients

Energy Technology Data Exchange (ETDEWEB)

Schueler, B; Walz-Flannigan, A [Mayo Clinic, Rochester, MN (United States)

2014-06-01

Purpose: To estimate patient radiation dose for whole spine imaging using EOS, a new biplanar slot-scanning radiographic system and compare with standard scoliosis radiography. Methods: The EOS imaging system (EOS Imaging, Paris, France) consists of two orthogonal x-ray fan beams which simultaneously acquire frontal and lateral projection images of a standing patient. The patient entrance skin air kerma was measured for each projection image using manufacturer-recommended exposure parameters for spine imaging. Organ and effective doses were estimated using a commercially-available Monte Carlo simulation program (PCXMC, STUK, Radiation and Nuclear Safety Authority, Helsinki, Finland) for a 15 year old mathematical phantom model. These results were compared to organ and effective dose estimated for scoliosis radiography using computed radiography (CR) with standard exposure parameters obtained from a survey of pediatric radiographic projections. Results: The entrance skin air kerma for EOS was found to be 0.18 mGy and 0.33 mGy for posterior-anterior (PA) and lateral projections, respectively. This compares to 0.76 mGy and 1.4 mGy for CR, PA and lateral projections. Effective dose for EOS (PA and lateral projections combined) is 0.19 mSv compared to 0.51 mSv for CR. Conclusion: The EOS slot-scanning radiographic system allows for reduced patient radiation dose in scoliosis patients as compared to standard CR radiography.

Hot super-dense compact object with particular EoS

Science.gov (United States)

Tito, E. P.; Pavlov, V. I.

2018-03-01

We show the possibility of existence of a self-gravitating spherically-symmetric equilibrium configuration for a neutral matter with neutron-like density, small mass M ≪ M_{⊙}, and small radius R ≪ R_{⊙}. We incorporate the effects of both the special and general theories of relativity. Such object may be formed in a cosmic cataclysm, perhaps an exotic one. Since the base equations of hydrostatic equilibrium are completed by the equation of state (EoS) for the matter of the object, we offer a novel, interpolating experimental data from high-energy physics, EoS which permits the existence of such compact system of finite radius. This EoS model possesses a critical state characterized by density ρc and temperature Tc. For such an object, we derive a radial distribution for the super-dense matter in "liquid" phase using Tolman-Oppenheimer-Volkoff equations for hydrostatic equilibrium. We demonstrate that a stable configuration is indeed possible (only) for temperatures smaller than the critical one. We derive the mass-radius relation (adjusted for relativistic corrections) for such small (M ≪ M_{⊙}) super-dense compact objects. The results are within the constraints established by both heavy-ion collision experiments and theoretical studies of neutron-rich matter.

Computer-assisted Orthopaedic Surgery: Current State and Future Perspective

Directory of Open Access Journals (Sweden)

Guoyan eZheng

2015-12-01

Full Text Available Introduced about two decades ago, computer-assisted orthopaedic surgery (CAOS has emerged as a new and independent area, due to the importance of treatment of musculoskeletal diseases in orthopaedics and traumatology, increasing availability of different imaging modalities, and advances in analytics and navigation tools. The aim of this paper is to present the basic elements of CAOS devices and to review state-of-the-art examples of different imaging modalities used to create the virtual representations, of different position tracking devices for navigation systems, of different surgical robots, of different methods for registration and referencing, and of CAOS modules that have been realized for different surgical procedures. Future perspectives will also be outlined.

[Orthopaedics' megalomania - myth or mobbing?

Science.gov (United States)

Gundtoft, Per Hviid; Brand, Eske; Klit, Jakob; Weisskirchner, Kristoffer Barfod

2016-12-12

It is a general impression in the world of medicine that orthopaedic surgeons differ from doctors of other specialities in terms of intellect and self-confidence. The purpose of this study was to evaluate the self-confidence of orthopaedics. We asked doctors from 30 different specialities to fill out a questionnaire. In addition to this, the participating orthopaedics were asked to rate their self-perceived surgical skills. In all, 120 orthopaedics and 416 non-orthopaedic doctors completed the questionnaire. There was no difference in GSE scores between orthopaedics and other doctors (p = 0.58). 98% of young orthopaedics estimated that their surgical talent was average or above average when compared with their colleagues on the same level of education. 72% believed that they were "equally talented", "more talented", or "far more talented" than their colleagues on a higher level of education. 76% believed that when assisting a senior surgeon the patients would "sometimes" (60%), "often" (14%) or "always" (2%) be better off if they were the ones performing the operation. More orthopaedics than non-orthopaedics believed that their speciality was regarded as one of the least important specialities in the world of medicine (p = 0.001). Orthopaedic surgeons in general are not more self-confident than other doctors or the average population, but young orthopaedic surgeons have a very high level of confidence in their own operation skills. none. none.

CONSTRAINING POLARIZED FOREGROUNDS FOR EoR EXPERIMENTS. I. 2D POWER SPECTRA FROM THE PAPER-32 IMAGING ARRAY

Energy Technology Data Exchange (ETDEWEB)

Kohn, S. A.; Aguirre, J. E.; Moore, D. F. [Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, PA (United States); Nunhokee, C. D.; Bernardi, G. [Department of Physics and Electronics, Rhodes University, Grahamstown (South Africa); Pober, J. C. [Department of Physics, Brown University, Providence, RI (United States); Ali, Z. S.; DeBoer, D. R.; Parsons, A. R. [Astronomy Department, University of California, Berkeley, CA (United States); Bradley, R. F. [Department of Electrical and Computer Engineering, University of Virginia, Charlottesville, VA (United States); Carilli, C. L. [National Radio Astronomy Observatory, Socorro, NM (United States); Gugliucci, N. E. [Saint Anselm College, Manchester, NH (United States); Jacobs, D. C. [School of Earth and Space Exploration, Arizona State University, Tempe, AZ (United States); Klima, P. [National Radio Astronomy Observatory, Charlottesville, VA (United States); MacMahon, D. H. E. [Radio Astronomy Laboratory, University of California, Berkeley, CA (United States); Manley, J. R.; Walbrugh, W. P. [SKA South Africa, Pinelands (South Africa); Stefan, I. I., E-mail: saulkohn@sas.upenn.edu [Cavendish Laboratory, Cambridge (United Kingdom)

2016-06-01

Current generation low-frequency interferometers constructed with the objective of detecting the high-redshift 21 cm background aim to generate power spectra of the brightness temperature contrast of neutral hydrogen in primordial intergalactic medium. Two-dimensional (2D) power spectra (power in Fourier modes parallel and perpendicular to the line of sight) that formed from interferometric visibilities have been shown to delineate a boundary between spectrally smooth foregrounds (known as the wedge ) and spectrally structured 21 cm background emission (the EoR window ). However, polarized foregrounds are known to possess spectral structure due to Faraday rotation, which can leak into the EoR window. In this work we create and analyze 2D power spectra from the PAPER-32 imaging array in Stokes I, Q, U, and V. These allow us to observe and diagnose systematic effects in our calibration at high signal-to-noise within the Fourier space most relevant to EoR experiments. We observe well-defined windows in the Stokes visibilities, with Stokes Q, U, and V power spectra sharing a similar wedge shape to that seen in Stokes I. With modest polarization calibration, we see no evidence that polarization calibration errors move power outside the wedge in any Stokes visibility to the noise levels attained. Deeper integrations will be required to confirm that this behavior persists to the depth required for EoR detection.

HDF-EOS Dump Tools

Science.gov (United States)

Prasad, U.; Rahabi, A.

2001-05-01

The following utilities developed for HDF-EOS format data dump are of special use for Earth science data for NASA's Earth Observation System (EOS). This poster demonstrates their use and application. The first four tools take HDF-EOS data files as input. HDF-EOS Metadata Dumper - metadmp Metadata dumper extracts metadata from EOS data granules. It operates by simply copying blocks of metadata from the file to the standard output. It does not process the metadata in any way. Since all metadata in EOS granules is encoded in the Object Description Language (ODL), the output of metadmp will be in the form of complete ODL statements. EOS data granules may contain up to three different sets of metadata (Core, Archive, and Structural Metadata). HDF-EOS Contents Dumper - heosls Heosls dumper displays the contents of HDF-EOS files. This utility provides detailed information on the POINT, SWATH, and GRID data sets. in the files. For example: it will list, the Geo-location fields, Data fields and objects. HDF-EOS ASCII Dumper - asciidmp The ASCII dump utility extracts fields from EOS data granules into plain ASCII text. The output from asciidmp should be easily human readable. With minor editing, asciidmp's output can be made ingestible by any application with ASCII import capabilities. HDF-EOS Binary Dumper - bindmp The binary dumper utility dumps HDF-EOS objects in binary format. This is useful for feeding the output of it into existing program, which does not understand HDF, for example: custom software and COTS products. HDF-EOS User Friendly Metadata - UFM The UFM utility tool is useful for viewing ECS metadata. UFM takes an EOSDIS ODL metadata file and produces an HTML report of the metadata for display using a web browser. HDF-EOS METCHECK - METCHECK METCHECK can be invoked from either Unix or Dos environment with a set of command line options that a user might use to direct the tool inputs and output . METCHECK validates the inventory metadata in (.met file) using The

EOS suspension test for the assessment of spinal flexibility in adolescent idiopathic scoliosis.

Science.gov (United States)

Hirsch, Caroline; Ilharreborde, Brice; Mazda, Keyvan

2015-07-01

The assessment of spinal flexibility is essential for the planning of adolescent idiopathic scoliosis (AIS) surgery. Various radiographic methods have been used but none of them has shown any superiority. The new low-dose stereography system EOS (EOS imaging, Paris, France) captures whole body images in a single scan without vertical distortion. EOS is now used in routine clinical use for AIS follow-up. The aim of this study was to prospectively evaluate the feasibility and the reproducibility of a new suspension test during the EOS imaging for the assessment of spinal flexibility in AIS. Fifty AIS patients scheduled for surgery were prospectively included. For each patient, a standard EOS radiograph was obtained, then a suspension test in the EOS and a classic traction test on the cotrel frame were performed. The examinations were compared in terms of radiation exposure, tolerance, mean traction force, and Cobb angle reduction for each curve. Axial and sagittal reductions during suspension were analyzed on three-dimensional EOS reconstructions. The tolerance of the suspension test was lower than the traction test but it was less operator dependent. Radiation exposure was 7 times lower during the suspension test. Cobb angle reductions achieved in the proximal and main curves by the two tests were similar. The traction test achieved greater reduction of the distal curve. Flexibility in the axial plane and in the sagittal plane was analyzed with the suspension test. The reduction in apical rotation was not correlated with the reduction in Cobb angle. The EOS suspension test can be used for the assessment of spinal flexibility in AIS. It gives a global vision of the deformity with new flexibility indices in the axial and sagittal planes.

Future Perspective and Long-Term Strategy of the Indian EO Programme

Science.gov (United States)

Rao, Mukund; Jayaraman, V.; Sridhara Murthi, K. R.; Kasturirangan, K.

EO technology development will continue to have profound effects on spatial information activities, as we are seeing it today - the changing demand of GIS technology to understanding processes around us and its representation as maps. In the longer term, information needs will drive further RS and GIS technological developments - creating stringent demands for technology solutions for spatial data capture, integration and representation. The emergence of Spatial Business from the highly volatile and dynamic synergy of information, technology and access will see a truly Spatial Society. EO will have a major impact on day-to-day life of nations, communities and even an individual. It will become the One-stop source for information - spatial information at that - thus enabling not only development oriented activities but also Business GIS, quality research and Info-savvy communities. Internationally, there will be a mix of Government and Commercial satellites vying to provide information services to a wide variety of users. EO satellites are also becoming smaller, efficient and less costlier. Almost 5-6 commercial systems will orbit around the Earth in the foreseeable future to generate massive, seamless archives of high-resolution panchromatic and multispectral images - almost reducing the need for aerial surveys for photography and mapping. Reaching resolution of cm level and covering narrower and more spectral bands, the trend is to IMAGE the Earth in its entirety and organize Image Infrastructures. The race will be to imaginatively capture the market with the fullest archive of the globe and cater to any imaging demand of users. One will also see efficient satellite operations that will enable imaging any part of the globe with minimum turn-around time - reaching concepts of IMAGING ON DEMAND. The need of the hour is looking forward now towards how the EO technology can adapt itself to the changing scenario and the steps to be taken to sustain use of EO data it in

The 2016 American Orthopaedic Association-Japanese Orthopaedic Association Traveling Fellowship.

Science.gov (United States)

Nandi, Sumon; Cho, Samuel K; Freedman, Brett A; Firoozabadi, Reza

2017-06-07

The American Orthopaedic Association-Japanese Orthopaedic Association (AOA-JOA) Traveling Fellowship, which began in 1992 as a collaborative effort between the 2 orthopaedic communities, is aimed at fostering leadership among early-career surgeons through clinical, academic, and cultural exchange. Over 3 weeks, we experienced an extraordinary journey that led us across nearly 800 miles of the picturesque Japanese countryside, with stops at 6 distinguished academic centers. The opportunity to become personally acquainted with orthopaedic leaders in Japan, learn from their experiences, and immerse ourselves in the ancient and storied culture of a beautiful country was one that we will not soon forget. Along the way, we accumulated a wealth of information while enjoying the legendary hospitality of the Japanese people. There is a ubiquitous challenge in delivering cost-effective, accessible health care while maintaining a commitment to education and research. The U.S. orthopaedic community may take solace in the fact that our Japanese colleagues stand with us as partners in this pursuit, and our relationship with them continues to grow stronger through endeavors such as the AOA-JOA Traveling Fellowship. We look forward to honoring our Japanese colleagues in 2017 when we host them in the United States.

EOS developments

Science.gov (United States)

Sindrilaru, Elvin A.; Peters, Andreas J.; Adde, Geoffray M.; Duellmann, Dirk

2017-10-01

CERN has been developing and operating EOS as a disk storage solution successfully for over 6 years. The CERN deployment provides 135 PB and stores 1.2 billion replicas distributed over two computer centres. Deployment includes four LHC instances, a shared instance for smaller experiments and since last year an instance for individual user data as well. The user instance represents the backbone of the CERNBOX service for file sharing. New use cases like synchronisation and sharing, the planned migration to reduce AFS usage at CERN and the continuous growth has brought EOS to new challenges. Recent developments include the integration and evaluation of various technologies to do the transition from a single active in-memory namespace to a scale-out implementation distributed over many meta-data servers. The new architecture aims to separate the data from the application logic and user interface code, thus providing flexibility and scalability to the namespace component. Another important goal is to provide EOS as a CERN-wide mounted filesystem with strong authentication making it a single storage repository accessible via various services and front- ends (/eos initiative). This required new developments in the security infrastructure of the EOS FUSE implementation. Furthermore, there were a series of improvements targeting the end-user experience like tighter consistency and latency optimisations. In collaboration with Seagate as Openlab partner, EOS has a complete integration of OpenKinetic object drive cluster as a high-throughput, high-availability, low-cost storage solution. This contribution will discuss these three main development projects and present new performance metrics.

A radiolucent chair for sitting-posture radiographs in non-ambulatory children: use in biplanar digital slot-scanning

International Nuclear Information System (INIS)

Bouloussa, Houssam; Dubory, Arnaud; Bachy, Manon; Seiler, Catherine; Morel, Baptiste; Vialle, Raphael

2015-01-01

EOS imaging (EOS System; EOS imaging, Paris, France) enables fast 2-D/3-D imaging of children in standing load-bearing position. Non-ambulatory children with neuromuscular scoliosis need evaluation of their spinal balance while in a normal daily position. We designed a customized chair fitting the EOS patient-area dimensions to obtain images in natural sitting postures. The chair is a 360 rotating orthopaedic chair made of fully radiolucent polyethylene and equipped with an adjustable headrest and three-point belts. Out of 41 consecutive patients, 36 (88%, 95% confidence interval 74-96%) had successful imaging. In most patients with severe neuromuscular trunk deformities, the EOS system combined with our chair was useful for assessing preoperative trunk collapse, pelvic obliquity and postoperative corrections in all planes. This specific device changed our daily practice for the assessment of spinal deformities in non-ambulatory patients. (orig.)

A radiolucent chair for sitting-posture radiographs in non-ambulatory children: use in biplanar digital slot-scanning

Energy Technology Data Exchange (ETDEWEB)

Bouloussa, Houssam; Dubory, Arnaud; Bachy, Manon [Universite Pierre et Marie Curie-Paris 6, Armand Trousseau Hospital, Department of Pediatric Orthopaedics, Paris Cedex 12 (France); Seiler, Catherine [Groupe Lagarrigue, Clichy (France); Morel, Baptiste [Universite Pierre et Marie Curie-Paris 6, Armand Trousseau Hospital, Department of Pediatric Imaging, Paris (France); Vialle, Raphael [Universite Pierre et Marie Curie-Paris 6, Armand Trousseau Hospital, Department of Pediatric Orthopaedics, Paris Cedex 12 (France); Armand Trousseau Hospital, The MAMUTH Hospital-University Department for Innovative Therapies in Musculoskeletal Diseases, Paris (France)

2015-11-15

EOS imaging (EOS System; EOS imaging, Paris, France) enables fast 2-D/3-D imaging of children in standing load-bearing position. Non-ambulatory children with neuromuscular scoliosis need evaluation of their spinal balance while in a normal daily position. We designed a customized chair fitting the EOS patient-area dimensions to obtain images in natural sitting postures. The chair is a 360 rotating orthopaedic chair made of fully radiolucent polyethylene and equipped with an adjustable headrest and three-point belts. Out of 41 consecutive patients, 36 (88%, 95% confidence interval 74-96%) had successful imaging. In most patients with severe neuromuscular trunk deformities, the EOS system combined with our chair was useful for assessing preoperative trunk collapse, pelvic obliquity and postoperative corrections in all planes. This specific device changed our daily practice for the assessment of spinal deformities in non-ambulatory patients. (orig.)

Evaluation of Pediatric Questions on the Orthopaedic In-Training Examination-An Update.

Science.gov (United States)

Murphy, Robert F; Nunez, Leah; Barfield, William R; Mooney, James F

2017-09-01

Pediatric orthopaedics is tested frequently on the Orthopaedic In-Training Examination (OITE). The most recent data on the pediatrics section of the OITE were generated from content 10 years old. The purpose of this study is to assess the pediatric orthopaedic questions on the 2011 to 2014 OITE, and to compare question categories and cognitive taxonomy with previous data. Four years (2011 to 2014) of OITE questions, answers, and references were reviewed. The number of pediatric questions per year was recorded, as well as presence of a clinical photo or imaging modality. Each question was categorized and assigned a cognitive taxonomy level. Categories included: knowledge; knowledge-treatment modalities; diagnosis; diagnosis/recognition of associated conditions; diagnosis/further studies; and diagnosis/treatment. Cognitive taxonomy levels included: simple recall, interpretation of data, and advanced problem-solving. The 3 most commonly covered topics were upper extremity trauma (17.4%), scoliosis (10.1%), and developmental dysplasia of the hip (5.7%). Compared with previous data, the percentage of pediatric questions was constant (13% vs. 14%). Categorically, the more recent OITE examinations contained significantly fewer questions testing simple knowledge (19% vs. 39%, P=0.0047), and significantly more questions testing knowledge of treatment modalities (17% vs. 9%, P=0.016) and diagnosis with associated conditions (19% vs. 9%, P=0.0034). Regarding cognitive taxonomy, there was a significant increase in the average number of questions that required advanced problem-solving (57% vs. 46%, P=0.048). Significantly more questions utilized clinical photographs and imaging studies (62% vs. 48%, P=0.012). The most common reference materials provided to support correct responses included Lovell and Winter's Pediatric Orthopaedics (25.7%) and the Journal of Pediatric Orthopaedics (23.4%). Although the percentage of pediatric questions on the OITE has remained essentially

Prospective study of irradiation and magnification on a pelvic imaging: EOS system versus conventional radiography

International Nuclear Information System (INIS)

Demoulin, Loic

2015-01-01

The pelvic x-ray is essential for the orthopedic practise. Recently, EOS system has been developed with technology to limit irradiation and theoretically not create magnification. The objective of this study was to evaluate the EOS system realizing a pelvic x-ray. All patients who underwent hip replacement between September 2014 and April 2015 have benefited pelvis radiograph with the 2 techniques, after surgery. The size of the head was measured with both techniques and compared to the established size. Irradiation of each technique was listed. A correlation study was carried out with the body mass index (BMI) of the patient. Irradiation was significantly greater with conventional radiography than with the EOS system: PDS of conventional radiography = 15.0 (10.5; 25.2) against the EOS system PDS = 8.2 (7.1; 9.7), p ≤0.0001. It was found a significant correlation between BMI and irradiation, particularly with conventional radiography. About expansion, the EOS system not create any except in 4 cases, unlike the conventional radiograph. The EOS system significantly decreases irradiation in all patients, compared to the conventional radiography, and it do not create magnification when realizing a pelvic x-ray, even in overweight patients [fr

East African Orthopaedic Journal: Submissions

African Journals Online (AJOL)

Author Guidelines. The East African Orthopaedic Journal is published biannually by the Kenya Orthopaedics Association. Its primary objective is to give researchers in orthopaedics and ... Format should be as follows; Details of authors as for original articles, summary of not more than 200 words, introduction, case report,

EO-1/Hyperion: Nearing Twelve Years of Successful Mission Science Operation and Future Plans

Science.gov (United States)

Middleton, Elizabeth M.; Campbell, Petya K.; Huemmrich, K. Fred; Zhang, Qingyuan; Landis, David R.; Ungar, Stephen G.; Ong, Lawrence; Pollack, Nathan H.; Cheng, Yen-Ben

2012-01-01

The Earth Observing One (EO-1) satellite is a technology demonstration mission that was launched in November 2000, and by July 2012 will have successfully completed almost 12 years of high spatial resolution (30 m) imaging operations from a low Earth orbit. EO-1 has two unique instruments, the Hyperion and the Advanced Land Imager (ALI). Both instruments have served as prototypes for NASA's newer satellite missions, including the forthcoming (in early 2013) Landsat-8 and the future Hyperspectral Infrared Imager (HyspIRI). As well, EO-1 is a heritage platform for the upcoming German satellite, EnMAP (2015). Here, we provide an overview of the mission, and highlight the capabilities of the Hyperion for support of science investigations, and present prototype products developed with Hyperion imagery for the HyspIRI and other space-borne spectrometers.

Electrical overstress (EOS) devices, circuits and systems

CERN Document Server

Voldman, Steven H

2013-01-01

Electrical Overstress (EOS) continues to impact semiconductor manufacturing, semiconductor components and systems as technologies scale from micro- to nano-electronics.  This bookteaches the fundamentals of electrical overstress  and how to minimize and mitigate EOS failures. The text provides a clear picture of EOS phenomena, EOS origins, EOS sources, EOS physics, EOS failure mechanisms, and EOS on-chip and system design.  It provides an illuminating insight into the sources of EOS in manufacturing, integration of on-chip, and system level EOS protection networks, followed by examples in spe

International Combined Orthopaedic Research Societies: A model for international collaboration to promote orthopaedic and musculoskeletal research

Directory of Open Access Journals (Sweden)

Theodore Miclau

2014-10-01

Full Text Available In October 2013, the International Combined Orthopaedic Research Societies (ICORS; http://i-cors.org was founded with inaugural member organisations from the previous Combined Orthopaedic Research Society, which had sponsored combined meetings for more than 2 decades. The ICORS is dedicated to the stimulation of orthopaedic and musculoskeletal research in fields such as biomedical engineering, biology, chemistry, and veterinary and human clinical research. The ICORS seeks to facilitate communication with member organisations to enhance international research collaborations and to promote the development of new international orthopaedic and musculoskeletal research organisations. Through new categories of membership, the ICORS represents the broadest coalition of orthopaedic research organisations globally.

Postoperative imaging of orthopaedic hardware in the hand and wrist: is there an added value for tomosynthesis?

Science.gov (United States)

De Silvestro, A; Martini, K; Becker, A S; Kim-Nguyen, T D L; Guggenberger, R; Calcagni, M; Frauenfelder, T

2018-02-01

To prospectively investigate digital tomosynthesis (DTS) as an alternative to digital radiography (DR) for postoperative imaging of orthopaedic hardware after trauma or arthrodesis in the hand and wrist. Thirty-six consecutive patients (12 female, median age 36 years, range 19-86 years) were included in this institutional review board approved clinical trial. Imaging was performed with DTS in dorso-palmar projection and DR was performed in dorso-palmar, lateral, and oblique views. Images were evaluated by two independent radiologists for qualitative and diagnosis-related imaging parameters using a four-point Likert scale (1=excellent, 4not diagnostic) and nominal scale. Interobserver agreement between the two readers was assessed with Cohen's kappa (k). Differences between DTS and CR were tested with Wilcoxon's signed-rank test. A p-value <0.05 was considered statistically significant. Regarding image quality, interobserver agreement was higher for DTS compared to DR, especially for fracture-related parameters (delineation osteosynthesis material [OSM]: K DTS 0.96 versus K DR 0.45; delineation fracture margins: K DTS 0.78 versus K DR 0.35). Delineation of fracture margins and delineation of adjacent joint spaces scored significant better for DTS compared to DR (delineation fracture margins: DTS1.54, DR2.28, p0.001; delineation adjacent joint spaces: DTS1.31, DR2.24, p0.001). Regarding diagnosis-related findings, interobserver agreement was almost equal. DTS showed a significant higher sharpness of fracture margins (DTS1.94, DR2.33, p0.04). Mean dose area product (DAP) for DTS was significant higher compared to DR (mean DR0.219 Gy·cm 2 , mean DTS0.903 Gy·cm 2 , p0.001). Fracture healing is more visible and interobserver agreement is higher for DTS compared to DR in the postoperative assessment of orthopaedic hardware in the hand and wrist. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Earth Observing System (EOS) Advanced Microwave Sounding Unit-A2 (EOS/AMSU-A): EOS Software Test Report

Science.gov (United States)

1998-01-01

This document describes the results of the formal qualification test (FQT)/ Demonstration conducted on September 10, and 14, 1998 for the EOS AMSU-A2 instrument. The purpose of the report is to relate the results of the functional performance and interface tests of the software. This is the final submittal of the EOS/AMSU-A Software Test report.

Research topics on EO systems for maritime platforms

NARCIS (Netherlands)

Dijk, J.; Bijl, P.; Broek, S.P. van den; Eijk, A.M.J. van

2014-01-01

Our world is constantly changing, and this has its effect on worldwide military operations. For example, there is a change from conventional warfare into a domain that contains asymmetric threats as well. The availability of high-quality imaging information from Electro-Optical (EO) sensors is of

Cumulative effective dose and cancer risk for pediatric population in repetitive full spine follow-up imaging: How micro dose is the EOS microdose protocol?

Science.gov (United States)

Law, Martin; Ma, Wang-Kei; Lau, Damian; Cheung, Kenneth; Ip, Janice; Yip, Lawrance; Lam, Wendy

2018-04-01

To evaluate and to obtain analytic formulation for the calculation of the effective dose and associated cancer risk using the EOS microdose protocol for scoliotic pediatric patients undergoing full spine imaging at different age of exposure; to demonstrate the microdose protocol capable of delivering lesser radiation dose and hence of further reducing cancer risk induction when compared with the EOS low dose protocol; to obtain cumulative effective dose and cancer risk for both genders scoliotic pediatrics of US and Hong Kong population using the microdose protocol. Organ absorbed doses of full spine exposed scoliotic pediatric patients have been simulated with the use of EOS microdose protocol imaging parameters input to the Monte Carlo software PCXMC. Gender and age specific effective dose has been calculated with the simulated organ absorbed dose using the ICRP-103 approach. The associated radiation induced cancer risk, expressed as lifetime attributable risk (LAR), has been estimated according to the method introduced in the Biological Effects of Ionizing Radiation VII report. Values of LAR have been estimated for scoliotic patients exposed repetitively during their follow up period at different age for US and Hong Kong population. The effective doses of full spine imaging with simultaneous posteroanterior and lateral projection for patients exposed at the age between 5 and 18 years using the EOS microdose protocol have been calculated within the range of 2.54-14.75 μSv. The corresponding LAR for US and Hong Kong population was ranged between 0.04 × 10 -6 and 0.84 × 10 -6 . Cumulative effective dose and cancer risk during follow-up period can be estimated using the results and are of information to patients and their parents. With the use of computer simulation and analytic formulation, we obtained the cumulative effective dose and cancer risk at any age of exposure for pediatric patients of US and Hong Kong population undergoing repetitive

HDF-EOS Web Server

Science.gov (United States)

Ullman, Richard; Bane, Bob; Yang, Jingli

2008-01-01

A shell script has been written as a means of automatically making HDF-EOS-formatted data sets available via the World Wide Web. ("HDF-EOS" and variants thereof are defined in the first of the two immediately preceding articles.) The shell script chains together some software tools developed by the Data Usability Group at Goddard Space Flight Center to perform the following actions: Extract metadata in Object Definition Language (ODL) from an HDF-EOS file, Convert the metadata from ODL to Extensible Markup Language (XML), Reformat the XML metadata into human-readable Hypertext Markup Language (HTML), Publish the HTML metadata and the original HDF-EOS file to a Web server and an Open-source Project for a Network Data Access Protocol (OPeN-DAP) server computer, and Reformat the XML metadata and submit the resulting file to the EOS Clearinghouse, which is a Web-based metadata clearinghouse that facilitates searching for, and exchange of, Earth-Science data.

History of orthopaedics in China: a brief review.

Science.gov (United States)

Li, Jia; Zhang, Yingze

2018-03-01

Chinese orthopaedic surgeons have made a substantial contribution to the development of orthopaedics worldwide, and traditional Chinese medicine (TCM) in orthopaedics has a very long history in China. We make a brief review of the development of orthopaedics in China, intending to pave the way for further understanding of Chinese orthopaedics for scholars all over the world. The description of fractures firstly appeared in 3600 years ago in China, and the theories, experience, and treatment strategies of TCM still play important roles in clinical diagnosis and treatment of orthopaedic disorders in our country. Western orthopaedics was first introduced into China in the early twentieth century. After decades of development, Chinese scholars have made some gratifying achievements in orthopaedics. Orthopaedics is constantly evolving, and we need to strengthen the ability of independent innovation to achieve orthopaedic surgeons' Chinese dream, and better serve our patients.

Image guidance in orthopaedics and traumatology: A historical perspective.

Science.gov (United States)

Székely, Gabor; Nolte, Lutz-P

2016-10-01

In this note we summarize the history of computer aided surgery in orthopaedics and traumatology from the end of the nineteenth century to currently observable future trends. We concentrate on the two major components of such systems, pre-operative planning and intra-operative execution. The evolution of the necessary technological components, the numerous platforms and components offered commercially as well as their clinical use are surveyed. Copyright © 2016. Published by Elsevier B.V.

Probing a steep EoS for dark energy with latest observations

Science.gov (United States)

Jaber, Mariana; Macorra, Axel de la

2018-01-01

We present a parametrization for the Dark Energy Equation of State "EoS" which has a rich structure, performing a transition at pivotal redshift zT between the present day value w0 to an early time wi =wa +w0 ≡ w(z ≫ 0) with a steepness given in terms of q parameter. The proposed parametrization is w =w0 +wa(z /zT) q /(1 +(z /zT)) q , with w0, wi, q and zT constant parameters. It reduces to the widely used EoS w =w0 +wa(1 - a) for zT = q = 1 . This transition is motivated by scalar field dynamics such as for example quintessence models. We study if a late time transition is favored by BAO measurements combined with local determination of H0 and information from the CMB. We find that our dynamical DE model allows to simultaneously fit H0 from local determinations and Planck CMB measurements, alleviating the tension obtained in a ΛCDM model. We obtain a smaller χ2 in our DE model than in ΛCDM showing that a dynamical DE is preferred with a reduction of 4.8%, 20.2% and 42.8% using BAO + H0, BAO + CMB and BAO + CMB + H0 datasets, respectively. However due to the increased number of free parameters in the EoS information criteria favors ΛCDM over our DE model at this stage. Nevertheless it is crucial to obtain the dynamics of DE from the observational data to show the path for theoretical DE models based on fundamental physics.

Terrestrial remote sensing science and algorithms planned for EOS/MODIS

Science.gov (United States)

Running, S. W.; Justice, C.O.; Salomonson, V.V.; Hall, D.; Barker, J.; Kaufmann, Y. J.; Strahler, Alan H.; Huete, A.R.; Muller, Jan-Peter; Vanderbilt, V.; Wan, Z.; Teillet, P.; Carneggie, David M. Geological Survey (U.S.) Ohlen

1994-01-01

The Moderate Resolution Imaging Spectroradiometer (MODIS) will be the primary daily global monitoring sensor on the NASA Earth Observing System (EOS) satellites, scheduled for launch on the EOS-AM platform in June 1998 and the EOS-PM platform in December 2000. MODIS is a 36 channel radiometer covering 0·415-14·235 μm wavelengths, with spatial resolution from 250 m to 1 km at nadir. MODIS will be the primary EOS sensor for providing data on terrestrial biospheric dynamics and process activity. This paper presents the suite of global land products currently planned for EOSDIS implementation, to be developed by the authors of this paper, the MODIS land team (MODLAND). These include spectral albedo, land cover, spectral vegetation indices, snow and ice cover, surface temperature and fire, and a number of biophysical variables that will allow computation of global carbon cycles, hydrologic balances and biogeochemistry of critical greenhouse gases. Additionally, the regular global coverage of these variables will allow accurate surface change detection, a fundamental determinant of global change.

Comparison of hyperspectral transformation accuracies of multispectral Landsat TM, ETM+, OLI and EO-1 ALI images for detecting minerals in a geothermal prospect area

Science.gov (United States)

Hoang, Nguyen Tien; Koike, Katsuaki

2018-03-01

Hyperspectral remote sensing generally provides more detailed spectral information and greater accuracy than multispectral remote sensing for identification of surface materials. However, there have been no hyperspectral imagers that cover the entire Earth surface. This lack points to a need for producing pseudo-hyperspectral imagery by hyperspectral transformation from multispectral images. We have recently developed such a method, a Pseudo-Hyperspectral Image Transformation Algorithm (PHITA), which transforms Landsat 7 ETM+ images into pseudo-EO-1 Hyperion images using multiple linear regression models of ETM+ and Hyperion band reflectance data. This study extends the PHITA to transform TM, OLI, and EO-1 ALI sensor images into pseudo-Hyperion images. By choosing a part of the Fish Lake Valley geothermal prospect area in the western United States for study, the pseudo-Hyperion images produced from the TM, ETM+, OLI, and ALI images by PHITA were confirmed to be applicable to mineral mapping. Using a reference map as the truth, three main minerals (muscovite and chlorite mixture, opal, and calcite) were identified with high overall accuracies from the pseudo-images (> 95% and > 42% for excluding and including unclassified pixels, respectively). The highest accuracy was obtained from the ALI image, followed by ETM+, TM, and OLI images in descending order. The TM, OLI, and ALI images can be alternatives to ETM+ imagery for the hyperspectral transformation that aids the production of pseudo-Hyperion images for areas without high-quality ETM+ images because of scan line corrector failure, and for long-term global monitoring of land surfaces.

Surgical simulation in orthopaedic skills training.

Science.gov (United States)

Atesok, Kivanc; Mabrey, Jay D; Jazrawi, Laith M; Egol, Kenneth A

2012-07-01

Mastering rapidly evolving orthopaedic surgical techniques requires a lengthy period of training. Current work-hour restrictions and cost pressures force trainees to face the challenge of acquiring more complex surgical skills in a shorter amount of time. As a result, alternative methods to improve the surgical skills of orthopaedic trainees outside the operating room have been developed. These methods include hands-on training in a laboratory setting using synthetic bones or cadaver models as well as software tools and computerized simulators that enable trainees to plan and simulate orthopaedic operations in a three-dimensional virtual environment. Laboratory-based training offers potential benefits in the development of basic surgical skills, such as using surgical tools and implants appropriately, achieving competency in procedures that have a steep learning curve, and assessing already acquired skills while minimizing concerns for patient safety, operating room time, and financial constraints. Current evidence supporting the educational advantages of surgical simulation in orthopaedic skills training is limited. Despite this, positive effects on the overall education of orthopaedic residents, and on maintaining the proficiency of practicing orthopaedic surgeons, are anticipated.

EoR imaging with the SKA: the challenge of foreground removal

Science.gov (United States)

Bonaldi, Anna

2018-05-01

21-cm observations of the Cosmic dawn (CD) and Epoch of Reionization (EoR) are one of the high priority science objectives for SKA Low. One of the most difficult aspects of the 21-cm measurement is the presence of foreground emission, due to our Galaxy and extragalactic sources, which is about four orders of magnitude brighter than the cosmological signal. While end-to-end simulations are being produced to investigate in details the foreground subtraction strategy, it is useful to complement this thorough but time-consuming approach with simpler, quicker ways to evaluate performance and identify possible critical steps. In this work, I present a forecast method, based on Bonaldi et al. (2015), Bonaldi & Ricciardi (2011), to understand the level of residual contamination after a component separation step, and its impact on our ability to investigate CD and EoR.

American Academy of Orthopaedic Surgeons

Science.gov (United States)

... Research Research Tools Research Roadmap Facts and Figures Unified Orthopaedic Research Agenda Sex and Gender in Research ... Career Center Clinician Scholar Career Development Clinician-Patient Communication Leadership Fellows Program Medical Student Resources Postgraduate Orthopaedic ...

Where Are the Women in Orthopaedic Surgery?

Science.gov (United States)

Rohde, Rachel S; Wolf, Jennifer Moriatis; Adams, Julie E

2016-09-01

Although women account for approximately half of the medical students in the United States, they represent only 13% of orthopaedic surgery residents and 4% of members of the American Academy of Orthopaedic Surgeons (AAOS). Furthermore, a smaller relative percentage of women pursue careers in orthopaedic surgery than in any other subspecialty. Formal investigations regarding the gender discrepancy in choice of orthopaedic surgery are lacking. (1) What reasons do women orthopaedic surgeons cite for why they chose this specialty? (2) What perceptions do women orthopaedic surgeons think might deter other women from pursuing this field? (3) What role does early exposure to orthopaedics and mentorship play in this choice? (4) What professional and personal choices do women in orthopaedics make, and how might this inform students who are choosing a career path? A 21-question survey was emailed to all active, candidate, and resident members of the Ruth Jackson Orthopaedic Society (RJOS, n = 556). RJOS is the oldest surgical women's organization incorporated in the United States. An independent orthopaedic specialty society, RJOS supports leadership training, mentorship, grant opportunities, and advocacy for its members and promotes sex-related musculoskeletal research. Although not all women in orthopaedic practice or training belong to RJOS, it is estimated that 42% of women AAOS fellows are RJOS members. Questions were formulated to determine demographics, practice patterns, and lifestyle choices of women who chose orthopaedic surgery as a specialty. Specifically, we evaluated the respondents' decisions about their careers and their opinions of why more women do not choose this field. For the purpose of this analysis, the influences and dissuaders were divided into three major categories: personal attributes, experience/exposure, and work/life considerations. The most common reasons cited for having chosen orthopaedic surgery were enjoyment of manual tasks (165 of 232

Critical roles of orthopaedic surgeon leadership in healthcare systems to improve orthopaedic surgical patient safety.

Science.gov (United States)

Kuo, Calvin C; Robb, William J

2013-06-01

The prevention of medical and surgical harm remains an important public health problem despite increased awareness and implementation of safety programs. Successful introduction and maintenance of surgical safety programs require both surgeon leadership and collaborative surgeon-hospital alignment. Documentation of success of such surgical safety programs in orthopaedic practice is limited. We describe the scope of orthopaedic surgical patient safety issues, define critical elements of orthopaedic surgical safety, and outline leadership roles for orthopaedic surgeons needed to establish and sustain a culture of safety in contemporary healthcare systems. We identified the most common causes of preventable surgical harm based on adverse and sentinel surgical events reported to The Joint Commission. A comprehensive literature review through a MEDLINE(®) database search (January 1982 through April 2012) to identify pertinent orthopaedic surgical safety articles found 14 articles. Where gaps in orthopaedic literature were identified, the review was supplemented by 22 nonorthopaedic surgical references. Our final review included 36 articles. Six important surgical safety program elements needed to eliminate preventable surgical harm were identified: (1) effective surgical team communication, (2) proper informed consent, (3) implementation and regular use of surgical checklists, (4) proper surgical site/procedure identification, (5) reduction of surgical team distractions, and (6) routine surgical data collection and analysis to improve the safety and quality of surgical patient care. Successful surgical safety programs require a culture of safety supported by all six key surgical safety program elements, active surgeon champions, and collaborative hospital and/or administrative support designed to enhance surgical safety and improve surgical patient outcomes. Further research measuring improvements from such surgical safety systems in orthopaedic care is needed.

Opacplot2: Enabling tabulated EoS and opacity compatibility for HEDLP simulations with the FLASH code

Science.gov (United States)

Laune, Jordan; Tzeferacos, Petros; Feister, Scott; Fatenejad, Milad; Yurchak, Roman; Flocke, Norbert; Weide, Klaus; Lamb, Donald

2017-10-01

Thermodynamic and opacity properties of materials are necessary to accurately simulate laser-driven laboratory experiments. Such data are compiled in tabular format since the thermodynamic range that needs to be covered cannot be described with one single theoretical model. Moreover, tabulated data can be made available prior to runtime, reducing both compute cost and code complexity. This approach is employed by the FLASH code. Equation of state (EoS) and opacity data comes in various formats, matrix-layouts, and file-structures. We discuss recent developments on opacplot2, an open-source Python module that manipulates tabulated EoS and opacity data. We present software that builds upon opacplot2 and enables easy-to-use conversion of different table formats into the IONMIX format, the native tabular input used by FLASH. Our work enables FLASH users to take advantage of a wider range of accurate EoS and opacity tables in simulating HELP experiments at the National Laser User Facilities.

Patient compliance and effect of orthopaedic shoes

DEFF Research Database (Denmark)

Philipsen, A B; Ellitsgaard, N; Krogsgaard, M R

1999-01-01

Orthopaedic shoes are individually handmade after a prescription from an orthopaedic surgeon, hence relatively expensive. Bad compliance is mentioned in the literature but not investigated. In order to evaluate patient compliance and the effect of orthopaedic shoes, 85 patients who were prescribed...

The Core Competencies for General Orthopaedic Surgeons.

Science.gov (United States)

Kellam, James F; Archibald, Douglas; Barber, James W; Christian, Eugene P; D'Ascoli, Richard J; Haynes, Richard J; Hecht, Suzanne S; Hurwitz, Shepard R; Kellam, James F; McLaren, Alexander C; Peabody, Terrance D; Southworth, Stephen R; Strauss, Robert W; Wadey, Veronica M R

2017-01-18

With the changing delivery of orthopaedic surgical care, there is a need to define the knowledge and competencies that are expected of an orthopaedist providing general and/or acute orthopaedic care. This article provides a proposal for the knowledge and competencies needed for an orthopaedist to practice general and/or acute care orthopaedic surgery. Using the modified Delphi method, the General Orthopaedic Competency Task Force consisting of stakeholders associated with general orthopaedic practice has proposed the core knowledge and competencies that should be maintained by orthopaedists who practice emergency and general orthopaedic surgery. For relevancy to clinical practice, 2 basic sets of competencies were established. The assessment competencies pertain to the general knowledge needed to evaluate, investigate, and determine an overall management plan. The management competencies are generally procedural in nature and are divided into 2 groups. For the Management 1 group, the orthopaedist should be competent to provide definitive care including assessment, investigation, initial or emergency care, operative or nonoperative care, and follow-up. For the Management 2 group, the orthopaedist should be competent to assess, investigate, and commence timely non-emergency or emergency care and then either transfer the patient to the appropriate subspecialist's care or provide definitive care based on the urgency of care, exceptional practice circumstance, or individual's higher training. This may include some higher-level procedures usually performed by a subspecialist, but are consistent with one's practice based on experience, practice environment, and/or specialty interest. These competencies are the first step in defining the practice of general orthopaedic surgery including acute orthopaedic care. Further validation and discussion among educators, general orthopaedic surgeons, and subspecialists will ensure that these are relevant to clinical practice. These

(Mis)perceptions about intimate partner violence in women presenting for orthopaedic care: a survey of Canadian orthopaedic surgeons.

Science.gov (United States)

Bhandari, Mohit; Sprague, Sheila; Tornetta, Paul; D'Aurora, Valerie; Schemitsch, Emil; Shearer, Heather; Brink, Ole; Mathews, David; Dosanjh, Sonia

2008-07-01

Domestic violence is the most common cause of nonfatal injury to women in North America. In a review of 144 such injuries, the second most common manifestation of intimate partner violence was musculoskeletal injuries (28%). The American Academy of Orthopaedic Surgeons is explicit that orthopaedic surgeons should play a role in the screening and appropriate identification of victims. We aimed to identify the perceptions, attitudes, and knowledge of Canadian orthopaedic surgeons with regard to intimate partner violence. We surveyed members of the Canadian Orthopaedic Association to identify attitudes toward intimate partner violence. With use of a systematic random sample, 362 surgeons were mailed questionnaires. The questionnaire consisted of three sections: (1) the general attitude of the orthopaedic surgeon toward intimate partner violence, (2) the attitude of the orthopaedic surgeon toward victims and batterers, and (3) the clinical relevance of intimate partner violence in orthopaedic surgery. Up to three follow-up mailings were performed to enhance response rates. A total of 186 orthopaedic surgeons responded (a response rate of 51%), and 167 (91%) of them were men. Most orthopaedic surgeons (95%) estimated that <10% of their patients were victims of intimate partner violence, and most respondents (80%) believed that it was exceedingly rare (a prevalence of <1%). The concept of mandatory screening for intimate partner violence was met with uncertainty by 116 surgeons (64%). Misconceptions were perpetuated by surgeons who believed that inquiring about intimate partner violence was an invasion of the victim's privacy, that investigating intimate partner violence was not part of their duty, that victims choose to be a victim, and that victims play a proactive role in causing their abuse. By the completion of the survey, the majority of surgeons (91%) believed that knowledge about intimate partner violence was relevant to their surgical practice. Discomfort with

Current status and progress of digital orthopaedics in China

Directory of Open Access Journals (Sweden)

Guo-Xian Pei

2014-07-01

Full Text Available Based on the development of digital medicine and digital anatomy, the concept of “digital orthopaedics” was raised by Pei Guo-Xian in China in 2006. The most striking feature of digital orthopaedics is the combination of basic and clinical orthopaedic knowledge with digital technology. In this review, we summarised the development of digital orthopaedics in China in recent years with respect to: the foundation of the Chinese Association of Digital Orthopedics, virtual human project (VHP, three-dimensional (3D reconstruction, finite element simulation, navigation in orthopaedic operations, and robot-assisted orthopaedic operations. In addition, we briefly reviewed digital orthopaedics in world leading institutes. We also looked into the future of digital orthopaedics in China and proposed the major challenges in digital technology and application in orthopaedics.

Accuracy and reliability of coronal and sagittal spinal curvature data based on patient-specific three-dimensional models created by the EOS 2D/3D imaging system.

Science.gov (United States)

Somoskeöy, Szabolcs; Tunyogi-Csapó, Miklós; Bogyó, Csaba; Illés, Tamás

2012-11-01

Three-dimensional (3D) deformations of the spine are predominantly characterized by two-dimensional (2D) angulation measurements in coronal and sagittal planes, using anteroposterior and lateral X-ray images. For coronal curves, a method originally described by Cobb and for sagittal curves a modified Cobb method are most widely used in practice, and these methods have been shown to exhibit good-to-excellent reliability and reproducibility, carried out either manually or by computer-based tools. Recently, an ultralow radiation dose-integrated radioimaging solution was introduced with special software for realistic 3D visualization and parametric characterization of the spinal column. Comparison of accuracy, correlation of measurement values, intraobserver and interrater reliability of methods by conventional manual 2D and sterEOS 3D measurements in a routine clinical setting. Retrospective nonrandomized study of diagnostic X-ray images created as part of a routine clinical protocol of eligible patients examined at our clinic during a 30-month period between July 2007 and December 2009. In total, 201 individuals (170 females, 31 males; mean age, 19.88 years) including 10 healthy athletes with normal spine and patients with adolescent idiopathic scoliosis (175 cases), adult degenerative scoliosis (11 cases), and Scheuermann hyperkyphosis (5 cases). Overall range of coronal curves was between 2.4° and 117.5°. Analysis of accuracy and reliability of measurements were carried out on a group of all patients and in subgroups based on coronal plane deviation: 0° to 10° (Group 1, n=36), 10° to 25° (Group 2, n=25), 25° to 50° (Group 3, n=69), 50° to 75° (Group 4, n=49), and more than 75° (Group 5, n=22). Coronal and sagittal curvature measurements were determined by three experienced examiners, using either traditional 2D methods or automatic measurements based on sterEOS 3D reconstructions. Manual measurements were performed three times, and sterEOS 3D

Orthopaedic research and education foundation and industry.

Science.gov (United States)

Wurth, Gene R; Sherr, Judy H; Coffman, Thomas M

2003-07-01

Members of orthopaedic industry commit a significant amount of funds each year to support research and education programs that are directly related to their product(s). In addition, industry supports organizations such as the Orthopaedic Research and Education Foundation. The relationship between the Orthopaedic Research and Education Foundation and industry began in the early 1980s. The support to the Orthopaedic Research and Education Foundation from industry primarily has come in the form of unrestricted grants. These grants best can be looked at as an investment rather than a contribution. This form of giving, once called corporate philanthropy is more accurately referred to as strategic philanthropy. Members of industry make these investments to enhance their reputations, build brand awareness, market their products and services, improve employee morale, increase customer loyalty, and establish strategic alliances. The specialty of orthopaedics is among the leaders in medicine in the amount of funding raised within the specialty for research and education programs. This is because of the amount of support from members of industry and the surgeons. During the past 15 years, 40% of the annual support to the Orthopaedic Research and Education Foundation has come from industry and the balance has come from surgeons and members of lay public. Future industry support of the Orthopaedic Research and Education Foundation and other organizations within the specialty of orthopaedics will be dependent on the continued demonstration of tangible returns in areas described.

Hand dominance in orthopaedic surgeons.

LENUS (Irish Health Repository)

Lui, Darren F

2012-08-01

Handedness is perhaps the most studied human asymmetry. Laterality is the preference shown for one side and it has been studied in many aspects of medicine. Studies have shown that some orthopaedic procedures had poorer outcomes and identified laterality as a contributing factor. We developed a questionnaire to assess laterality in orthopaedic surgery and compared this to an established scoring system. Sixty-two orthopaedic surgeons surveyed with the validated Waterloo Handedness Questionnaire (WHQ) were compared with the self developed Orthopaedic Handedness Questionnaire (OHQ). Fifty-eight were found to be right hand dominant (RHD) and 4 left hand dominant (LHD). In RHD surgeons, the average WHQ score was 44.9% and OHQ 15%. For LHD surgeons the WHQ score was 30.2% and OHQ 9.4%. This represents a significant amount of time using the non dominant hand but does not necessarily determine satisfactory or successful dexterity transferable to the operating room. Training may be required for the non dominant side.

Origins of eponymous orthopaedic equipment.

Science.gov (United States)

Meals, Clifton; Wang, Jeffrey

2010-06-01

Orthopaedists make great use of eponymous equipment, however the origins of these tools are unknown to many users. This history enriches, enlightens, and enhances surgical education, and may inspire modern innovation. We explored the origins of common and eponymous orthopaedic equipment. We selected pieces of equipment named for their inventors and in the broadest use by modern orthopaedists. We do not describe specialized orthopaedic implants and instruments owing to the overwhelming number of these devices. The history of this equipment reflects the coevolution of orthopaedics and battlefield medicine. Additionally, these stories evidence the primacy of elegant design and suggest that innovation is often a process of revision and refinement rather than sudden inspiration. Their history exposes surgical innovators as brilliant, lucky, hardworking, and sometimes odd. These stories amuse, enlighten, and may inspire modern orthopaedists to develop creative solutions of their own. The rich history of the field's eponymous instruments informs an ongoing tradition of innovation in orthopaedics.

April 2006. 32 Major Orthopaedic Procedures

African Journals Online (AJOL)

user

2006-04-01

Apr 1, 2006 ... Major Orthopaedic Procedures: 17 Year Trends. Biruk Lambisso Wamisho1 ... financial and logistic constraints with poor compliance of ... Modern orthopaedic surgery is very expensive. A highly ..... Case management. Tribury.

Starck Ta PTW strength model recommendation for use with SESAME 93524 EoS

Energy Technology Data Exchange (ETDEWEB)

Sjue, Sky K. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Prime, Michael Bruce [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2017-02-27

The purpose of this document is to provide a calibration of the Preston-Tonks- Wallace (PTW) strength model for use with the new SESAME equation of state (EoS) 93524. The calibration data included in this t spans temperatures from 198 K to 673 K and strain rates from 0.001/s to 3200/s.

Orthopaedic Footwear Design

Science.gov (United States)

1992-01-01

Although the need for orthopaedic shoes is increasing, the number of skilled shoemakers has declined. This has led to the development of a CAD/CAM system to design and fabricate, orthopaedic footwear. The NASA-developed RIM database management system is the central repository for CUSTOMLAST's information storage. Several other modules also comprise the system. The project was initiated by Langley Research Center and Research Triangle Institute in cooperation with the Veterans Administration and the National Institute for Disability and Rehabilitation Research. Later development was done by North Carolina State University and the University of Missouri-Columbia. The software is licensed by both universities.

Cross calibration of the Landsat-7 ETM+ and EO-1 ALI sensor

Science.gov (United States)

Chander, G.; Meyer, D.J.; Helder, D.L.

2004-01-01

As part of the Earth Observer 1 (EO-1) Mission, the Advanced Land Imager (ALI) demonstrates a potential technological direction for Landsat Data Continuity Missions. To evaluate ALI's capabilities in this role, a cross-calibration methodology has been developed using image pairs from the Landsat-7 (L7) Enhanced Thematic Mapper Plus (ETM+) and EO-1 (ALI) to verify the radiometric calibration of ALI with respect to the well-calibrated L7 ETM+ sensor. Results have been obtained using two different approaches. The first approach involves calibration of nearly simultaneous surface observations based on image statistics from areas observed simultaneously by the two sensors. The second approach uses vicarious calibration techniques to compare the predicted top-of-atmosphere radiance derived from ground reference data collected during the overpass to the measured radiance obtained from the sensor. The results indicate that the relative sensor chip assemblies gains agree with the ETM+ visible and near-infrared bands to within 2% and the shortwave infrared bands to within 4%.

Limited Range Sesame EOS for Ta

Energy Technology Data Exchange (ETDEWEB)

Greeff, Carl William [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Crockett, Scott [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Rudin, Sven Peter [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Burakovsky, Leonid [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2017-03-30

A new Sesame EOS table for Ta has been released for testing. It is a limited range table covering T ≤ 26, 000 K and ρ ≤ 37.53 g/cc. The EOS is based on earlier analysis using DFT phonon calculations to infer the cold pressure from the Hugoniot. The cold curve has been extended into compression using new DFT calculations. The present EOS covers expansion into the gas phase. It is a multi-phase EOS with distinct liquid and solid phases. A cold shear modulus table (431) is included. This is based on an analytic interpolation of DFT calculations.

Leadership and business education in orthopaedic residency training programs.

Science.gov (United States)

Kiesau, Carter D; Heim, Kathryn A; Parekh, Selene G

2011-01-01

Leadership and business challenges have become increasingly present in the practice of medicine. Orthopaedic residency programs are at the forefront of educating and preparing orthopaedic surgeons. This study attempts to quantify the number of orthopaedic residency programs in the United States that include leadership or business topics in resident education program and to determine which topics are being taught and rate the importance of various leadership characteristics and business topics. A survey was sent to all orthopaedic department chairpersons and residency program directors in the United States via e-mail. The survey responses were collected using a survey collection website. The respondents rated the importance of leadership training for residents as somewhat important. The quality of character, integrity, and honesty received the highest average rating among 19 different qualities of good leaders in orthopaedics. The inclusion of business training in resident education was also rated as somewhat important. The topic of billing and coding received the highest average rating among 14 different orthopaedically relevant business topics. A variety of topics beyond the scope of clinical practice must be included in orthopaedic residency educational curricula. The decreased participation of newly trained orthopaedic surgeons in leadership positions and national and state orthopaedic organizations is concerning for the future of orthopaedic surgery. Increased inclusion of leadership and business training in resident education is important to better prepare trainees for the future.

Clinical application of helical CT 3D reconstruction for the dental orthopaedics

International Nuclear Information System (INIS)

Han Benyi; Jiang Xiaolu; Li Hongru

2005-01-01

Objective: To evaluate the clinical application of helical CT 3D reconstruction technique in the dental orthopaedics. Methods: The helical CT was performed with 3.0 mm slice thickness and 1.0 pitch in 41 patients with dental orthopaedics. The 3D reconstructions, including maximum intensity projection (MIP), surface shaded display (SSD), and multiplanar reconstructions (MPR), were made for all the cases. Results: Thirty-seven of the 41 patients showed malalignment, tilt, rotation, overlap of the teeth and the different space between the longitudinal axes of the teeth. Twenty-five cases of them have shown 36 buried teeth in all. The axial images covered all the information. SSD demonstrated the external contours and entire morphologies of the teeth and the mandible with the relationship of the teeth alignment and the mandible. MIP clearly manifested the full view and the longitudinal alignment of the teeth. Among the 36 buried teeth, there were 29 palatally and 7 labially presented teeth, and they were morphologically delineated on MIP through various angles. Conclusion: The helical CT 3D reconstruction is a new technique to display the stereoscopic configuration of teeth. The combination of axial images and MIP, SSD, and MPR provides valuable anatomic and diagnostic information helpful for the surgeons to structure and determine the treatment protocol for the dental orthopaedics. (authors)

A watershed model to integrate EO data

Science.gov (United States)

Jauch, Eduardo; Chambel-Leitao, Pedro; Carina, Almeida; Brito, David; Cherif, Ines; Alexandridis, Thomas; Neves, Ramiro

2013-04-01

. The LCLU maps are coupled with a database that transforms land use into model properties through lookup tables. The LAI maps, usually based on NDVI satellite images, can be used directly as input to the model. When the vegetation growth is being simulated, the use of a LAI distributed in space improve the model results, by improving, for example, the estimated evapotranspiration, the estimated values of biomass, the nutrient uptake, etc. MOHID LAND calculates a Reference Evapotranspiration (rEVTP), based on the meteorological properties. The Actual Evapotranspiration (aEVTP) is then computed based on vegetation transpiration, soil evaporation and the available water in soil. Alternatively, EO derived maps of EVTP can be used as input to the model, in the place of the rEVTP, or even in the place of the aEVTP, both being provided as boundary condition. The same can be done with SWC maps, that can be used to initialize the model soil water content. The integration of EO data with MOHID LAND was tested and is being continuously developed and applied for support farmers and to help water managers to improve the water management.

Radiologic examination of orthopaedics. Methods and techniques

International Nuclear Information System (INIS)

Hafner, E.; Meuli, H.C.

1976-01-01

This volume describes in detail radiological examinations of the skeleton modern procedures in orthopaedic surgery. Special emphasis is given to functional examination techniques based upon the authors' extensive work on standardized radiological examinations best suited to the needs of orthopaedic surgeons. These techniques were developed at the Radiodiagnostic Department of the Central Radiological Clinic, Bern University, in cooperation with the University Clinic of Orthopaedics and Surgery of the Locomotor System. Exposure techniques are explained concisely, yet with extraordinary precision and attention to detail. They have proved highly successful in teaching programs for X-ray technicians and as standard examination techniques for many hospitals, X-ray departments, orthopaedic units, and private clinics. Recommended for orthopaedic surgeons, radiologists, general surgeons, and X-ray technicians, this definitive treatise, with its superb X-ray reproductions and complementary line drawings, explains how to achieve improved diagnoses and standardized control with the least possible radiation exposure to the patient

The financial impact of orthopaedic fellowship training.

Science.gov (United States)

Gaskill, Trevor; Cook, Chad; Nunley, James; Mather, R Chad

2009-07-01

Previous reports have compared the expected financial return of a medical education with those expected in other professions. However, we know of no published report estimating the financial return of orthopaedic training. The purpose of this study was to estimate the financial incentives that may influence the decision to invest an additional year of training in each of the major orthopaedic fellowships. With survey data from the American Academy of Orthopaedic Surgeons and using standard financial techniques, we calculated the estimated return on investment of an additional year of orthopaedic training over a working lifetime. The net present value, internal rate of return, and the break-even point were estimated. Eight fellowships were examined and compared with general orthopaedic practice. Investment in an orthopaedic fellowship yields variable returns. Adult spine, shoulder and elbow, sports medicine, hand, and adult arthroplasty may yield positive returns. Trauma yields a neutral return, while pediatrics and foot and ankle have negative net present values. On the basis of mean reported incomes, the break-even point was two years for spine, seven years for hand, eight years for shoulder and elbow, twelve years for adult arthroplasty, thirteen years for sports medicine, and twenty-seven years for trauma. Fellowship-trained pediatric and foot and ankle surgeons did not break even following the initial investment. When working hours were controlled for, the returns for adult arthroplasty and trauma became negative. The financial return of an orthopaedic fellowship varies on the basis of the specialty chosen. While reasons to pursue fellowship training vary widely, and many are not financial, there are positive and negative financial incentives. Therefore, the decision to pursue fellowship training is best if it is not made on the basis of financial incentives. This information may assist policy makers in analyzing medical education economics to ensure the

Orthopaedic training in Kenya | Mulimba | East African Orthopaedic ...

African Journals Online (AJOL)

Objective: To do a survey of the current orthopaedic specialists in Kenya's training since their first medical degrees. Determine the duration, facilities and methods of training. Methods: A number of doctors trained under different arrangements were identified, interviewed and where curriculum was available this was read.

1 venous thromboembolism in orthopaedics references

African Journals Online (AJOL)

2008-05-23

2004; 126: 338-400S. 3. American Academy of Orthopaedic Surgeons. American Academy of orthopaedic Surgeons clinical guidelines on prevention of symptomatic pulmonary embolism in patients undergoing total hip or knee arthroplasty.www.aaos.org/Research/ guidelines/PE_guideline. Pdf (accessed May 23, 2008). 4.

Nigerian Journal of Orthopaedics and Trauma

African Journals Online (AJOL)

The Nigerian Journal of Orthopaedics and Trauma publishes original papers, review articles and case reports on pathology, anaesthesia, orthopaedics and trauma. Vol 12, No 1 (2013). DOWNLOAD FULL TEXT Open Access DOWNLOAD FULL TEXT Subscription or Fee Access. Table of Contents. Articles. Management of ...

Biomaterials in orthopaedics

Science.gov (United States)

Navarro, M; Michiardi, A; Castaño, O; Planell, J.A

2008-01-01

At present, strong requirements in orthopaedics are still to be met, both in bone and joint substitution and in the repair and regeneration of bone defects. In this framework, tremendous advances in the biomaterials field have been made in the last 50 years where materials intended for biomedical purposes have evolved through three different generations, namely first generation (bioinert materials), second generation (bioactive and biodegradable materials) and third generation (materials designed to stimulate specific responses at the molecular level). In this review, the evolution of different metals, ceramics and polymers most commonly used in orthopaedic applications is discussed, as well as the different approaches used to fulfil the challenges faced by this medical field. PMID:18667387

Quality of life during orthopaedic training and academic practice. Part 1: orthopaedic surgery residents and faculty.

Science.gov (United States)

Sargent, M Catherine; Sotile, Wayne; Sotile, Mary O; Rubash, Harry; Barrack, Robert L

2009-10-01

A pilot study of two academic training programs revealed concerning levels of resident burnout and psychological dysfunction. The purpose of the present study was to determine the quality of life of orthopaedic residents and faculty on a national scale and to identify risk factors for decompensation. Three hundred and eighty-four orthopaedic residents and 264 full-time orthopaedic faculty members completed a voluntary, anonymous survey consisting of three validated instruments (the Maslach Burnout Inventory, the General Health Questionnaire-12, and the Revised Dyadic Adjustment Scale) and question sets assessing demographic information, relationship issues, stress reactions/management, and work/life balance. High levels of burnout were seen in 56% of the residents and 28% of the faculty members. Burnout risk was greatest among second-postgraduate-year residents and residents in training programs with six or more residents per postgraduate year. Sixteen percent of residents and 19% of faculty members reported symptoms of psychological distress. Sleep deprivation was common among the residents and correlated positively with every distress measure. Faculty reported greater levels of stress but greater satisfaction with work and work/life balance. A number of factors, such as making time for hobbies and limiting alcohol use, correlated with decreased dysfunction for both residents and faculty. Despite reporting high levels of job satisfaction, orthopaedic residents and faculty are at risk for burnout and distress. Identification of protective factors and risk factors may provide guidance to improve the quality of life of academic orthopaedic surgeons in training and beyond.

Communication skills training in orthopaedics.

Science.gov (United States)

Lundine, Kristopher; Buckley, Richard; Hutchison, Carol; Lockyer, Jocelyn

2008-06-01

Communication skills play a key role in many aspects of both medical education and clinical patient care. The objectives of this study were to identify the key components of communication skills from the perspectives of both orthopaedic residents and their program directors and to understand how these skills are currently taught. This study utilized a mixed methods design. Quantitative data were collected with use of a thirty-item questionnaire distributed to all Canadian orthopaedic residents. Qualitative data were collected through focus groups with orthopaedic residents and semistructured interviews with orthopaedic program directors. One hundred and nineteen (37%) of 325 questionnaires were completed, twelve residents participated in two focus groups, and nine of sixteen program directors from across the country were interviewed. Both program directors and residents identified communication skills as being the accurate and appropriate use of language (i.e., content skills), not how the communication was presented (i.e., process skills). Perceived barriers to effective communication included time constraints and the need to adapt to the many personalities and types of people encountered daily in the hospital. Residents rarely have explicit training in communication skills. They rely on communication training implicitly taught through observation of their preceptors and clinical experience interacting with patients, peers, and other health-care professionals. Orthopaedic residents and program directors focus on content and flexibility within communication skills as well as on the importance of being concise. They value the development of communication skills in the clinical environment through experiential learning and role modeling. Education should focus on developing residents' process skills in communication. Care should be taken to avoid large-group didactic teaching sessions, which are perceived as ineffective.

Spectral mixture analysis for water quality assessment over the Amazon floodplain using Hyperion/EO-1 images

Directory of Open Access Journals (Sweden)

Lênio Soares Galvão

2006-12-01

Full Text Available Water composition undergoes complex spatial and temporal variations throughout the central Amazon floodplain. This study analyzed the spectral mixtures of the optically active substances (OASs in water with spaceborne hyperspectral images. The test site was located upstream the confluence of Amazon (white water and Tapajós (clear-water rivers, where two Hyperion images were acquired from the Earth Observing One (EO-1 satellite. The first image was acquired on September 16, 2001, during the falling water period of the Amazon River. The second image was acquired on June 23, 2005, at the end of the high water period. The images were pre-processed to remove stripes of anomalous pixels, convert radiance-calibrated data to surface reflectance, mask land, clouds and macrophytes targets, and spectral subset the data within the range of 457-885nm. A sequential procedure with the techniques Minimum Noise Fraction (MNF, Pixel Purity Index (PPI and n-dimensional visualization of the MNF feature space was employed to select end-members from both images. A single set of end-members was gathered to represent the following spectrally unique OASs: clear-water; dissolved organic matter; suspended sediments; and phytoplankton. The Linear Spectral Unmixing algorithm was applied to each Hyperion image in order to map the spatial distribution of these constituents, in terms of sub-pixel fractional abundances. Results showed three patterns of changes in the water quality from high to falling flood periods: decrease of suspended inorganic matter concentration in the Amazon River; increase of suspended inorganic matter and phytoplankton concentrations in varzea lakes; and increase of phytoplankton concentration in the Tapajós River.

Spectral mixture analysis for water quality assessment over the Amazon floodplain using Hyperion/EO-1 images

Directory of Open Access Journals (Sweden)

Lênio Soares Galvão

2007-06-01

Full Text Available Water composition undergoes complex spatial and temporal variations throughout the central Amazon floodplain. This study analyzed the spectral mixtures of the optically active substances (OASs in water with spaceborne hyperspectral images. The test site was located upstream the confluence of Amazon (white water and Tapajós (clear-water rivers, where two Hyperion images were acquired from the Earth Observing One (EO-1 satellite. The first image was acquired on September 16, 2001, during the falling water period of the Amazon River. The second image was acquired on June 23, 2005, at the end of the high water period. The images were pre-processed to remove stripes of anomalous pixels, convert radiance-calibrated data to surface reflectance, mask land, clouds and macrophytes targets, and spectral subset the data within the range of 457-885nm. A sequential procedure with the techniques Minimum Noise Fraction (MNF, Pixel Purity Index (PPI and n-dimensional visualization of the MNF feature space was employed to select end-members from both images. A single set of end-members was gathered to represent the following spectrally unique OASs: clear-water; dissolved organic matter; suspended sediments; and phytoplankton. The Linear Spectral Unmixing algorithm was applied to each Hyperion image in order to map the spatial distribution of these constituents, in terms of sub-pixel fractional abundances. Results showed three patterns of changes in the water quality from high to falling flood periods: decrease of suspended inorganic matter concentration in the Amazon River; increase of suspended inorganic matter and phytoplankton concentrations in varzea lakes; and increase of phytoplankton concentration in the Tapajós River.

Mands for Information Using "How" Under EO-Absent and EO-Present Conditions.

Science.gov (United States)

Shillingsburg, M Alice; Bowen, Crystal N; Valentino, Amber L

2014-06-01

The present study replicates and extends previous research on teaching "How?" mands for information to children with autism. The experimental preparation involved mand training in the context of completing preferred activities and included training and testing under conditions when the establishing operation (EO) was present and absent. Results show that two children with autism acquired mands for information using How? only in situations where information was valuable (i.e., the EO was present); they then consistently made use of the information provided in activity completion. Generalization to novel, untaught situations was assessed.

Consultation of orthopaedics cases using multimedia messaging services.

Science.gov (United States)

Eranki, Vivek; Munt, Justin; Lim, Ming J; Atkinson, Robert

2010-04-23

Frequently, radiological data is transferred verbally between the Emergency Department (ED) and orthopaedic registrar. Given the different language skills and medical experience of health staff, there is often a limit to the adequacy of the verbal description that could lead to suboptimal patient care. This study proposes that concurrent review of MMS teleradiology with traditional verbal reporting results in a significant therapeutic benefit. Case notes of 40 patients who presented to ED were reviewed. Images were captured and sent to an Orthopaedic registrar along with a brief clinical synopsis. Information was collected on the diagnosis of the MMS radiograph, need for urgent admission and management plan outlined to ED. Correct diagnosis was made in 27 of 40 cases. Using the latest technology available, MMS teleradiology had 79% sensitivity, 83% specificity and an accuracy of 80%. 50% of paediatric fractures and 60% of undisplaced fractures were diagnosed successfully. MMS teleradiology is not suitable by itself as a remote diagnostic tool. However, when combined with existing clinical practice, it is effective in screening patients, enhances confidence in decision making and communication between doctors.

Organ dose and effective dose with the EOS scanner in spine deformity surgery

DEFF Research Database (Denmark)

Heide Pedersen, Peter; Petersen, Asger Greval; Eiskjær, Søren Peter

2016-01-01

Organ dose and effective dose with the EOS scanner in spine deformity surgery. A study on anthropomorphic phantoms describing patient radiation exposure in full spine examinations. Authors: Peter Heide Pedersen, Asger Greval Petersen, Søren Peter Eiskjær. Background: Ionizing radiation potentially...... quality images while at the same time reducing radiation dose. At our institution we use the EOS for pre- and postoperative full spine examinations. Purpose: The purpose of the study is to make first time organ dose and effective dose evaluations with micro-dose settings in full spine examinations. Our...... hypothesis is that organ dose and effective doses can be reduced 5-10 times compared to standard settings, without too high image-quality trade off, resulting in a theoretical reduction of radiation induced cancer. Methods: Patient dosimetry is performed on anthropomorphic child phantoms, representing a 5...

Scaling the EOS namespace

CERN Document Server

Peters, Andreas J; Bitzes, Georgios

2017-01-01

EOS is the distributed storage system being developed at CERN with the aim of fulfilling a wide range of data storage needs, ranging from physics data to user home directories. Being in production since 2011, EOS currently manages around 224 petabytes of disk space and 1.4 billion files across several instances. Even though individual EOS instances routinely manage hundreds of disk servers, users access the contents through a single, unified namespace which is exposed by the head node (MGM), and contains the metadata of all files stored on that instance. The legacy implementation keeps the entire namespace in-memory. Modifications are appended to a persistent, on-disk changelog; this way, the in-memory contents can be reconstructed after every reboot by replaying the changelog. While this solution has proven reliable and effective, we are quickly approaching the limits of its scalability. In this paper, we present our new implementation which is currently in testing. We have designed and implemented QuarkD...

An information revolution in orthopaedics.

Science.gov (United States)

Goldberg, A J; MacGregor, A; Spencer, S A

2012-04-01

With the established success of the National Joint Registry and the emergence of a range of new national initiatives for the capture of electronic data in the National Health Service, orthopaedic surgery in the United Kingdom has found itself thrust to the forefront of an information revolution. In this review we consider the benefits and threats that this revolution poses, and how orthopaedic surgeons should marshal their resources to ensure that this is a force for good.

Racial and ethnic diversity in orthopaedic surgery residency programs.

Science.gov (United States)

Okike, Kanu; Utuk, Mekeme E; White, Augustus A

2011-09-21

Although the U.S. population is increasingly diverse, the field of orthopaedic surgery has historically been less diverse. The purpose of this study was to quantify the representation of racial and ethnic minorities among orthopaedic surgery residents compared with those in other fields of medicine and to determine how these levels of diversity have changed over time. We determined the representation of minorities among residents in orthopaedic surgery and in other fields by analyzing the Graduate Medical Education reports published annually by the Journal of the American Medical Association (JAMA), which provided data for African-Americans from 1968 to 2008, Hispanics from 1990 to 2008, Asians from 1995 to 2008, and American Indians/Alaskan Natives and Native Hawaiians/Pacific Islanders from 2001 to 2008. During the 1990s and 2000s, representation among orthopaedic residents increased rapidly for Asians (+4.53% per decade, p < 0.0001) and gradually for Hispanics (+1.37% per decade, p < 0.0001) and African-Americans (+0.68% per decade, p = 0.0003). Total minority representation in orthopaedics averaged 20.2% during the most recent years studied (2001 to 2008), including 11.7% for Asians, 4.0% for African-Americans, 3.8% for Hispanics, 0.4% for American Indians/Alaskan Natives, and 0.3% for Native Hawaiians/Pacific Islanders. However, orthopaedic surgery was significantly less diverse than all of the other residencies examined during this time period (p < 0.001). This was due primarily to the lower representation of Hispanics and Asians in orthopaedic surgery than in any of the other fields of medicine. Minority representation in orthopaedic residency programs has increased over time for Asians, Hispanics, and African-Americans. In spite of these gains, orthopaedic surgery has remained the least diverse of the specialty training programs considered in this study. While further efforts are needed to determine the factors underlying this lack of representation, we

ASY-EOS experiment at GSI

Directory of Open Access Journals (Sweden)

Kezzar K.

2012-07-01

Full Text Available The elliptic-flow ratio of neutrons with respect to protons in reactions of neutron rich Heavy-Ion at intermediate energies has been recently proposed as an observable sensitive to the strength of the symmetry term in the nuclear equation of state (EOS at supra-saturation densities. The recent results obtained from the existing FOPI/LAND data for 197Au+197Au collisions at 400 MeV/nucleon in comparison with the UrQMD model allowed a first estimate of the symmetry term of the EOS but suffer from a considerable statistical uncertainty. In order to obtain an improved data set for Au+Au collisions and to extend the study to other systems, a new experiment was carried out at the GSI laboratory by the ASY-EOS collaboration in May 2011.

Mentorship in orthopaedic and trauma residency training ...

African Journals Online (AJOL)

Background: Mentorship is important in residency training as it is necessary for personal and professional development of the resident trainees. Objectives: This study documents mentorship in orthopaedic residency training programme in Nigeria by assessing the awareness of orthopaedic residents on the role of a mentor, ...

Surgical site infection among patients undergone orthopaedic ...

African Journals Online (AJOL)

Surgical site infection among patients undergone orthopaedic surgery at Muhimbili Orthopaedic Institute, Dar es Salaam, Tanzania. ... of surgical site infection at Muhimbili Orthopedic Institute was high. This was associated with more than 2 hours length of surgery, lack of prophylaxis use, and pre-operative hospital stay.

The burden of gunshot injuries on orthopaedic healthcare resources in South Africa.

Science.gov (United States)

Martin, Case; Thiart, Gerhard; McCollum, Graham; Roche, Stephen; Maqungo, Sithombo

2017-06-30

Injuries inflicted by gunshot wounds (GSWs) are an immense burden on the South African (SA) healthcare system. In 2005, Allard and Burch estimated SA state hospitals treated approximately 127 000 firearm victims annually and concluded that the cost of treating an abdominal GSW was approximately USD1 467 per patient. While the annual number of GSW injuries has decreased over the past decade, an estimated 54 870 firearm-related injuries occurred in SA in 2012. No study has estimated the burden of these GSWs from an orthopaedic perspective. To estimate the burden and average cost of treating GSW victims requiring orthopaedic interventions in an SA tertiary level hospital. This retrospective study surveyed more than 1 500 orthopaedic admissions over a 12-month period (2012) at Groote Schuur Hospital, Cape Town, SA. Chart review subsequently yielded data that allowed analysis of cost, theatre time, number and type of implants, duration of admission, diagnostic imaging studies performed, blood products used, laboratory studies ordered and medications administered. A total of 111 patients with an average age of 28 years (range 13 - 74) were identified. Each patient was hit by an average of 1.69 bullets (range 1 - 7). These patients sustained a total of 147 fractures, the majority in the lower extremities. Ninety-five patients received surgical treatment for a total of 135 procedures, with a cumulative surgical theatre time of >306 hours. Theatre costs, excluding implants, were in excess of USD94 490. Eighty of the patients received a total of 99 implants during surgery, which raised theatre costs an additional USD53 381 cumulatively, or USD667 per patient. Patients remained hospitalised for an average of 9.75 days, and total ward costs exceeded USD130 400. Individual patient costs averaged about USD2 940 (ZAR24 945) per patient. This study assessed the burden of orthopaedic firearm injuries in SA. It was estimated that on average, treating an orthopaedic GSW patient

Dose, image quality and spine modeling assessment of biplanar EOS micro-dose radiographs for the follow-up of in-brace adolescent idiopathic scoliosis patients.

Science.gov (United States)

Morel, Baptiste; Moueddeb, Sonia; Blondiaux, Eleonore; Richard, Stephen; Bachy, Manon; Vialle, Raphael; Ducou Le Pointe, Hubert

2018-05-01

The aim of this study was to compare the radiation dose, image quality and 3D spine parameter measurements of EOS low-dose and micro-dose protocols for in-brace adolescent idiopathic scoliosis (AIS) patients. We prospectively included 25 consecutive patients (20 females, 5 males) followed for AIS and undergoing brace treatment. The mean age was 12 years (SD 2 years, range 8-15 years). For each patient, in-brace biplanar EOS radiographs were acquired in a standing position using both the conventional low-dose and micro-dose protocols. Dose area product (DAP) was systematically recorded. Diagnostic image quality was qualitatively assessed by two radiologists for visibility of anatomical structures. The reliability of 3D spine modeling between two operators was quantitatively evaluated for the most clinically relevant 3D radiological parameters using intraclass correlation coefficient (ICC). The mean DAP for the posteroanterior and lateral acquisitions was 300 ± 134 and 433 ± 181 mGy cm 2 for the low-dose radiographs, and 41 ± 19 and 81 ± 39 mGy cm 2 for micro-dose radiographs. Image quality was lower with the micro-dose protocol. The agreement was "good" to "very good" for all measured clinical parameters when comparing the low-dose and micro-dose protocols (ICC > 0.73). The micro-dose protocol substantially reduced the delivered dose (by a factor of 5-7 compared to the low-dose protocol) in braced children with AIS. Although image quality was reduced, the micro-dose protocol proved to be adapted to radiological follow-up, with adequate image quality and reliable clinical measurements. These slides can be retrieved under Electronic Supplementary Material.

Smartphone apps for orthopaedic sports medicine - a smart move?

Science.gov (United States)

Wong, Seng Juong; Robertson, Greg A; Connor, Katie L; Brady, Richard R; Wood, Alexander M

2015-01-01

With the advent of smartphones together with their downloadable applications (apps), there is increasing opportunities for doctors, including orthopaedic sports surgeons, to integrate such technology into clinical practice. However, the clinical reliability of these medical apps remains questionable. We reviewed available apps themed specifically towards Orthopaedic Sports Medicine and related conditions and assessed the level of medical professional involvement in their design and content, along with a review of these apps. The most popular smartphone app stores (Android, Apple, Blackberry, Windows, Samsung, Nokia) were searched for Orthopaedic Sports medicine themed apps, using the search terms; Orthopaedic Sports Medicine, Orthopaedics, Sports medicine, Knee Injury, Shoulder Injury, Anterior Cruciate Ligament Tear, Medial Collateral Ligament Tear, Rotator Cuff Tear, Meniscal Tear, Tennis Elbow. All English language apps related to orthopaedic sports medicine were included. A total of 76 individual Orthopaedic Sports Medicine themed apps were identified. According to app store classifications, there were 45 (59 %) medical themed apps, 28 (37 %) health and fitness themed apps, 1 (1 %) business app, 1 (1 %) reference app and 1 (1 %) sports app. Forty-nine (64 %) apps were available for download free of charge. For those that charged access, the prices ranged from £0.69 to £69.99. Only 51 % of sports medicine apps had customer satisfaction ratings and 39 % had named medical professional involvement in their development or content. We found the majority of Orthopaedic Sports Medicine apps had no named medical professional involvement, raising concerns over their content and evidence-base. We recommend increased regulation of such apps to improve the accountability of app content.

Developmental orthopaedic diseases in foals

International Nuclear Information System (INIS)

Şİrİn, Özlem; Alkan, Zeki

2010-01-01

Developmental Orthopaedic Diseases (DOD) is seen frequently in horses which completed their maturity. Osteochondrosis, physitis, angular limb deformities, flexural deformities, juvenil arthritis, cervical vertebral anomalies, cuboidal bone abnormalities are problems investigated under Developmental Orthopaedic Diseases title. This diseases can develop single or some together in fast growing, heavy animals (especially Arabian and English Thoroughbreds). Multifactorial causes of this diseases etiopathogenesis can be listed as genetic predisposition, trauma, nutrition, vitamins/minerals and endocrine disorders. But the exact causes of these diseases are not known. In this review detailed information are given about the diseases mentioned above

A Clinico- Epidemiological Study Of Filarial Related Orthopaedic Manifestations

Directory of Open Access Journals (Sweden)

Patond K.R

1992-01-01

Full Text Available An epidemiological study was undertaken to study the incidence and distribution of orthopaedic manifestations of filariasis in an endemic area. A total of 207 cases were clinically examined and investigated. Patients were divided into three groups , viz., Group A: Orthopaedic manifestations with no history of filariasis . Group B: Orthopaedic manifestations with history of filariasis such as microfilaraemia or filarial fevers etc., Group C: Orthopaedic manifestations with chronic manifestations such as elephantiasis, hydrocele etc. To confirm filarial etiology, all the cases were examined for the presence of filarial antibody by indirect ELISA using wuchereda bancrofti microfilarial excretory- secretary antigen (wd Mf ESAg . A total of 61 of 102 patients of Group A, 14 of 21 patients of group B, and 73 of 84 patients of Group C were positive for filarial antibody. This study showed the prevalence of filarial antibody in about 71.4% of various orthopaedic manifestations.

Converting from XML to HDF-EOS

Science.gov (United States)

Ullman, Richard; Bane, Bob; Yang, Jingli

2008-01-01

A computer program recreates an HDF-EOS file from an Extensible Markup Language (XML) representation of the contents of that file. This program is one of two programs written to enable testing of the schemas described in the immediately preceding article to determine whether the schemas capture all details of HDF-EOS files.

[Orthopaedic day surgery in Emilia-Romagna].

Science.gov (United States)

Rolli, M; Rodler, M; Petropulacos, K; Baldi, R

2001-09-01

It is well known that the organizational model of day surgery, concerning surgical problems defined by the literature as minor, has the aim of optimising the use of hospital resources and facilitating patients and their families, from a psychological and social point of view, by reducing hospitalisation time and the associated complications, and ensuring the same efficacy and more appropriateness of treatment. This study is firstly aimed at analysing the impact that the healthcare policy of the Emilia Romagna Region has had on the development of day surgery practice. Secondly, it compares the patients treated in orthopaedic day surgery in the hospitals of Bologna, Modena, Ferrara, Parma, Reggio Emilia, Maggiore hospital of Bologna and Rizzoli Orthopaedic Institute of Bologna (II.OO.R). In the period 1997-2000 there was a marked increase in the number of operations carried out in day surgery in all of the above-mentioned hospitals. Also in the unispecialistic orthopaedic hospital there was a surprising increase in the percentage of operations carried out in day surgery with respect to the total number of operations performed. The aim of the Rizzoli Orthopaedic Institute and the Emilia Romagna Region is to further implement this form of healthcare, contextually potentiating the appropriateness of hospital admission and avoiding, when not necessary, other forms of healthcare.

Vapor-liquid, liquid-liquid and vapor-liquid-liquid equilibrium of binary and multicomponent systems with MEG modeling with the CPA EoS and an EoS/G(E) model

DEFF Research Database (Denmark)

Folas, Georgios; Kontogeorgis, Georgios; Michelsen, Michael Locht

2006-01-01

The cubic-plus-association (CPA) EoS is applied to multicomponent multiphase equilibria of systems containing MEG as a hydrate inhibitor. It is shown that the model provides very satisfactory prediction of the phase behavior for the systems tested. A more conventional engineering model for handling...

Radiation exposure to the eye lens of orthopaedic surgeons during various orthopaedic procedures

International Nuclear Information System (INIS)

Romanova, K.; Alyakov, M.; Vassileva, J.

2015-01-01

The aim of the present study was to assess the radiation dose to the eye lens of orthopaedic surgeons during various orthopaedic procedures and to make efforts to ensure that radiation protection is optimised. The study was performed for Fractura femoris and Fractura cruris procedures performed in orthopaedic operating theatres, as well as for fractures of wrist, ankle and hand/ shoulder performed in the emergency trauma room. The highest mean value of the eye lens dose of 47.2 μSv and higher mean fluoroscopy time of 3 min, as well as the corresponding highest maximum values of 77.1 μSv and 5.0 min were observed for the Fractura femoris procedure performed with the Biplanar 500e fluoroscopy systems. At a normal workload, the estimated mean annual dose values do not exceed the annual occupational dose limit for the lens of eye, but at a heavy workload in the department, this dose limit could be achieved or exceeded. The use of protective lead glasses is recommended as they could reduce the radiation exposure of the lens of the eye. The phantom measurements demonstrated that the use of half-dose mode could additionally reduce dose to the operator's eye lens. (authors)

On-Call Communication in Orthopaedic Trauma: "A Picture Is Worth a Thousand Words"--A Survey of OTA Members.

Science.gov (United States)

Molina, Cesar S; Callan, Alexandra K; Burgos, Eduardo J; Mir, Hassan R

2015-05-01

To quantify the effects of varying clinical communication styles (verbal and pictorial) on the ability of orthopaedic trauma surgeons in understanding an injury and formulate an initial management plan. A Research Electronic Data Capture survey was e-mailed to all OTA members. Respondents quantified (5-point Likert scale) how confident they felt understanding an injury and establishing an initial management plan based on the information provided for 5 common orthopaedic trauma scenarios. Three verbal descriptions were created for each scenario and categorized as limited, moderate, or detailed. The questions were repeated with the addition of a radiographic image and then repeated a third time including a clinical photograph. Statistical evaluation consisted of descriptive statistics and Kruskal-Wallis analyses using STATA (version 12.0). Of the 221 respondents, there were a total of 95 who completed the entire survey. Nearly all were currently taking call (92/95 = 96.8%) and the majority were fellowship trained (79/95 = 83.2%). Most practice at a level I trauma center (58/95 = 61.1%) and work with orthopaedic residents (62/95 = 65.3%). There was a significant increase in confidence scores between a limited, moderate, and detailed description in all clinical scenarios for understanding the injury and establishing an initial management plan (P 0.05). The addition of images in the form of radiographs and/or clinical photographs greatly improves the confidence of orthopaedic trauma surgeons in understanding injuries and establishing initial management plans with limited verbal information (P communicating providers.

Modeling and performance assessment in QinetiQ of EO and IR airborne reconnaissance systems

Science.gov (United States)

Williams, John W.; Potter, Gary E.

2002-11-01

QinetiQ are the technical authority responsible for specifying the performance requirements for the procurement of airborne reconnaissance systems, on behalf of the UK MoD. They are also responsible for acceptance of delivered systems, overseeing and verifying the installed system performance as predicted and then assessed by the contractor. Measures of functional capability are central to these activities. The conduct of these activities utilises the broad technical insight and wide range of analysis tools and models available within QinetiQ. This paper focuses on the tools, methods and models that are applicable to systems based on EO and IR sensors. The tools, methods and models are described, and representative output for systems that QinetiQ has been responsible for is presented. The principle capability applicable to EO and IR airborne reconnaissance systems is the STAR (Simulation Tools for Airborne Reconnaissance) suite of models. STAR generates predictions of performance measures such as GRD (Ground Resolved Distance) and GIQE (General Image Quality) NIIRS (National Imagery Interpretation Rating Scales). It also generates images representing sensor output, using the scene generation software CAMEO-SIM and the imaging sensor model EMERALD. The simulated image 'quality' is fully correlated with the predicted non-imaging performance measures. STAR also generates image and table data that is compliant with STANAG 7023, which may be used to test ground station functionality.

Inpatient consultations to an orthopaedic service: the hidden workload.

LENUS (Irish Health Repository)

O'Malley, N T

2011-12-01

While the quality and efficiency of out-patient orthopaedic referrals are well documented in the literature, there is little on the standard and appropriateness of inpatient orthopaedic consultations.

Global EOS: exploring the 300-ms-latency region

Science.gov (United States)

Mascetti, L.; Jericho, D.; Hsu, C.-Y.

2017-10-01

EOS, the CERN open-source distributed disk storage system, provides the highperformance storage solution for HEP analysis and the back-end for various work-flows. Recently EOS became the back-end of CERNBox, the cloud synchronisation service for CERN users. EOS can be used to take advantage of wide-area distributed installations: for the last few years CERN EOS uses a common deployment across two computer centres (Geneva-Meyrin and Budapest-Wigner) about 1,000 km apart (∼20-ms latency) with about 200 PB of disk (JBOD). In late 2015, the CERN-IT Storage group and AARNET (Australia) set-up a challenging R&D project: a single EOS instance between CERN and AARNET with more than 300ms latency (16,500 km apart). This paper will report about the success in deploy and run a distributed storage system between Europe (Geneva, Budapest), Australia (Melbourne) and later in Asia (ASGC Taipei), allowing different type of data placement and data access across these four sites.

EOS7R: Radionuclide transport for TOUGH2

International Nuclear Information System (INIS)

Oldenburg, C.M.; Pruess, K.

1995-11-01

EOS7R provides radionuclide transport capability for TOUGH2. EOS7R extends the EOS7 module (water, brine, and optional air) to model water, brine, parent component, daughter component, and optional air and heat. The radionuclide components follow a first-order decay law, and may adsorb onto the solid grains. Volatilization of the decaying components is modeled by Henry's Law. The decaying components are normally referred to as radionuclides, but they may in fact by any trace components that decay, adsorb, and volatilize. The decay process need not be radioactive decay, but could be any process that follows a first-order decay law, such as biodegradation. EOS7R includes molecular diffusion for all components in gaseous and aqueous phases using a simplified binary diffusion model. When EOS7R is used with standard TOUGH2, transport occurs by advection and molecular diffusion in all phases. When EOS7R is coupled with the dispersion module T2DM, one obtains T2DMR, the radionuclide transport version of T2DM. T2DMR models advection, diffusion, and hydrodynamic dispersion in rectangular two-dimensional regions. Modeling of radionuclide transport requires input parameters specifying the half-life for first-order decay, distribution coefficients for each rock type for adsorption, and inverse Henry's constants for volatilization. Options can be specified in the input file to model decay in inactive grid blocks and to read from standard EOS7 INCON files. The authors present a number of example problems to demonstrate application and accuracy of TOUGH2/EOS7R. One-dimensional simulation results agree well with analytical solutions. For a two-dimensional salt-dome flow problem, the final distribution of daughter radionuclide component is complicated by the presence of weak recirculation caused by density effects due to salinity

Smartphones in orthopaedics.

Science.gov (United States)

Al-Hadithy, Nawfal; Gikas, Panagiotis D; Al-Nammari, Shafic Said

2012-08-01

With the introduction of the European Working Time Directive, surgical trainees are facing limited training opportunities and doctors are required to maximise their training opportunities. Smartphone sales have been rapidly increasing over the last five years and can be used as a training tool for the orthopaedic trainee and surgeon. Common uses include applications (AO, eLogbook and PubMed), Ebooks, online Logbooks, Guidelines and surgical techniques. In addition, smartphones can be used to immediately complete work-based assessments, in the absence of computers, hopefully increasing completion rates and reliability. Some journals now provide podcasts and video tutorials which may be accessed on smartphones, which is useful for higher examinations. Smartphones can also be used in the clinical setting to take photographs of wounds. Smartphones are enjoying increased uptake and application in the workplace and we review their use for orthopaedic surgeons and trainees to allow them to make the most out of their training opportunities.

Tree Canopy Characterization for EO-1 Reflective and Thermal Infrared Validation Studies: Rochester, New York

Science.gov (United States)

Ballard, Jerrell R., Jr.; Smith, James A.

2002-01-01

The tree canopy characterization presented herein provided ground and tree canopy data for different types of tree canopies in support of EO-1 reflective and thermal infrared validation studies. These characterization efforts during August and September of 2001 included stem and trunk location surveys, tree structure geometry measurements, meteorology, and leaf area index (LAI) measurements. Measurements were also collected on thermal and reflective spectral properties of leaves, tree bark, leaf litter, soil, and grass. The data presented in this report were used to generate synthetic reflective and thermal infrared scenes and images that were used for the EO-1 Validation Program. The data also were used to evaluate whether the EO-1 ALI reflective channels can be combined with the Landsat-7 ETM+ thermal infrared channel to estimate canopy temperature, and also test the effects of separating the thermal and reflective measurements in time resulting from satellite formation flying.

Comparison of GERG-2008 and simpler EoS models in calculation of phase equilibrium and physical properties of natural gas related systems

DEFF Research Database (Denmark)

Varzandeh, Farhad; Stenby, Erling Halfdan; Yan, Wei

2017-01-01

Accurate description of thermodynamic properties of natural gas systems is of great significance in the oil and gas industry. For this application, non-cubic equations of state (EoSs) are advantageous due to their better density and compressibility description. Among the non-cubic models, GERG-2008...... is a new wide-range EoS for natural gases and other mixtures of 21 natural gas components. It is considered as a standard reference equation suitable for natural gas applications where highly accurate thermodynamic properties are required. Soave's modification of Benedict-Webb-Rubin (Soave-BWR) Eo......S is another model that despite its empirical nature, provides accurate density description even around the critical point. It is much simpler than GERG-2008 and easier to handle and generalize to reservoir oil fluids. This study presents a comprehensive comparison between GERG-2008 and other cubic (SRK and PR...

Social Media in Pediatric Orthopaedics.

Science.gov (United States)

Lander, Sarah T; Sanders, James O; Cook, Peter C; O'Malley, Natasha T

Internet searches and social media utilization in health care has exploded over the past 5 years, and patients utilize it to gain information on their health conditions and physicians. Social media has the potential to serve as a means for education, communication, and marketing in all health care specialties. Physicians are sometimes reluctant to engage because of concerns of privacy, litigation, and lack of experience with this modality. Many surgical subspecialties have capitalized on social media but no study to date has examined the specific footprint of pediatric orthopaedic surgeons in this realm. We aim to quantify the utilization of individual social media platforms by pediatric orthopaedic surgeons, and identify any differences between private and hospital-based physicians, but also regional differences. Using the Pediatric Orthopaedic Society of North America Member Directory, each active member's social media presence was reviewed through an Internet search. Members were stratified on the basis of practice model and geographic location. Individual Internet searches, social media sites, and number of publications were reviewed for social media presence. Of 987 Pediatric Orthopaedic Society of North America members, 95% had a professional webpage, 14.8% a professional Facebook page, 2.2% a professional Twitter page, 36.8% a LinkedIn profile, 25.8% a ResearchGate profile, 33% at least 1 YouTube. Hospital-based physicians had a lower mean level of utilization of social media compared with their private practice peers, and a higher incidence of Pubmed publications. Private practice physicians had double the social media utilization. Regional differences reveal that practicing Pediatric Orthopaedists in the Northeast had increased utilization of ResearchGate and LinkedIn and the West had the lowest mean social media utilization levels. The rapid expansion of social media usage by patients and their family members is an undeniable force affecting the health

PCR IN TRAUMATOLOGY AND ORTHOPAEDICS: METHOD DESCRIPTION AND APPLICABILITY

Directory of Open Access Journals (Sweden)

E. M. Polyakova

2014-01-01

Full Text Available Review brief presents description of polymerase chain reaction method (PCR and its most common variants. Three PCR-based lines of research, carried out in the traumatology and orthopaedics, include identifying a causative agents of the implant-associated infection after orthopaedic surgery; detection of antibiotic resistance genes and biofilm forming genes. It was shown that PCR can be used as additional method for detection of genetic disorders, significant for traumatology and orthopaedics, and for investigation of cartilage and bone regeneration.

Using financial incentives to improve value in orthopaedics.

Science.gov (United States)

Lansky, David; Nwachukwu, Benedict U; Bozic, Kevin J

2012-04-01

A variety of reforms to traditional approaches to provider payment and benefit design are being implemented in the United States. There is increasing interest in applying these financial incentives to orthopaedics, although it is unclear whether and to what extent they have been implemented and whether they increase quality or reduce costs. We reviewed and discussed physician- and patient-oriented financial incentives being implemented in orthopaedics, key challenges, and prerequisites to payment reform and value-driven payment policy in orthopaedics. We searched the MEDLINE database using as search terms various provider payment and consumer incentive models. We retrieved a total of 169 articles; none of these studies met the inclusion criteria. For incentive models known to the authors to be in use in orthopaedics but for which no peer-reviewed literature was found, we searched Google for further information. Provider financial incentives reviewed include payments for reporting, performance, and patient safety and episode payment. Patient incentives include tiered networks, value-based benefit design, reference pricing, and value-based purchasing. Reform of financial incentives for orthopaedic surgery is challenged by (1) lack of a payment/incentive model that has demonstrated reductions in cost trends and (2) the complex interrelation of current pay schemes in today's fragmented environment. Prerequisites to reform include (1) a reliable and complete data infrastructure; (2) new business structures to support cost sharing; and (3) a retooling of patient expectations. There is insufficient literature reporting the effects of various financial incentive models under implementation in orthopaedics to know whether they increase quality or reduce costs. National concerns about cost will continue to drive experimentation, and all anticipated innovations will require improved collaboration and data collection and reporting.

Exponential 6 parameterization for the JCZ3-EOS

Energy Technology Data Exchange (ETDEWEB)

McGee, B.C.; Hobbs, M.L.; Baer, M.R.

1998-07-01

A database has been created for use with the Jacobs-Cowperthwaite-Zwisler-3 equation-of-state (JCZ3-EOS) to determine thermochemical equilibrium for detonation and expansion states of energetic materials. The JCZ3-EOS uses the exponential 6 intermolecular potential function to describe interactions between molecules. All product species are characterized by r*, the radius of the minimum pair potential energy, and {var_epsilon}/k, the well depth energy normalized by Boltzmann`s constant. These parameters constitute the JCZS (S for Sandia) EOS database describing 750 gases (including all the gases in the JANNAF tables), and have been obtained by using Lennard-Jones potential parameters, a corresponding states theory, pure liquid shock Hugoniot data, and fit values using an empirical EOS. This database can be used with the CHEETAH 1.40 or CHEETAH 2.0 interface to the TIGER computer program that predicts the equilibrium state of gas- and condensed-phase product species. The large JCZS-EOS database permits intermolecular potential based equilibrium calculations of energetic materials with complex elemental composition.

Analytic EoS and PTW strength model recommendation for Starck Ta

Energy Technology Data Exchange (ETDEWEB)

Sjue, Sky K. [Los Alamos National Laboratory; Prime, Michael Bruce [Los Alamos National Laboratory

2016-09-01

The purpose of this document is to provide an analytic EoS and PTW strength model for Starck Ta that can be consistently used between different platforms and simulations at three labs. This should provide a consistent basis for comparison of the results of calculations, but not the best implementation for matching a wide variety of experimental data. Another version using SESAME tables should follow, which will provide a better physical representation over a broader range of conditions. The data sets available at the time only include one Hopkinson bar at a strain rate of 1800/s; a broader range of high-rate calibration data would be preferred. The resulting fit gives the PTW parameter p = 0. To avoid numerical issues, p = 0:001 has been used in FLAG. The PTW parameters that apply above the maximum strain rate in the data use the values from the original publication.

Orthopaedic admissions due to sports and recreation injuries.

LENUS (Irish Health Repository)

Delaney, R A

2009-02-01

The health benefits of exercise may be attenuated by sports and recreation related injury (SRI). Though the majority of SRI are mild and self-limiting, a significant number are serious and require orthopaedic intervention. The aims of this study were to assess the burden of these serious injuries on the orthopaedic inpatient service, and to investigate potential target areas for injury prevention. All 1,590 SRI seen in the ED over a 3-month period were analysed using the Patient Information Management System to determine which patients received inpatient orthopaedic care. The medical records of those 63 patients who required inpatient care under orthopaedics were reviewed and data collected on demographic features, history, operative procedure and theatre resources, and length of hospital stay. Data were analyzed using SPSS. SRI accounted for 12.3% of all ED presentations. The principal activities resulting in injury requiring orthopaedic care were soccer, hurling and informal play e.g. trampoline. Falls made up 37% of the overall mechanism of injury but 68% of the injuries severe enough to require operative management. Most operative procedures were performed as part of a routine day trauma list but 20% were performed out of hours. This group of injuries places a significant burden on a busy trauma service. Injury prevention measures such as public education regarding falls in sport may have a role in reducing this burden.

Safety syringes and anti-needlestick devices in orthopaedic surgery.

Science.gov (United States)

Sibbitt, Wilmer L; Band, Philip A; Kettwich, Lawrence G; Sibbitt, Cristina R; Sibbitt, Lori J; Bankhurst, Arthur D

2011-09-07

The American Academy of Orthopaedic Surgery (AAOS), The Joint Commission, the Occupational Safety and Health Administration (OSHA), and the Needlestick Safety and Prevention Act encourage the integration of safety-engineered devices to prevent needlestick injuries to health-care workers and patients. We hypothesized that safety syringes and needles could be used in outpatient orthopaedic injection and aspiration procedures. The study investigated the orthopaedic uses and procedural idiosyncrasies of safety-engineered devices, including (1) four safety needles (Eclipse, SafetyGlide, SurGuard, and Magellan), (2) a mechanical safety syringe (RPD), (3) two automatic retractable syringes (Integra, VanishPoint), (4) three manual retractable syringes (Procedur-SF, Baksnap, Invirosnap), and (5) three shielded syringes (Safety-Lok, Monoject, and Digitally Activated Shielded [DAS] Syringe). The devices were first tested ex vivo, and then 1300 devices were used for 425 subjects undergoing outpatient arthrocentesis, intra-articular injections, local anesthesia, aspiration biopsy, and ultrasound-guided procedures. During the clinical observation, there were no accidental needlesticks (0 needlesticks per 1300 devices). Safety needles could be successfully used on a Luer syringe but were limited to ≤1.5 in (≤3.81 cm) in length and the shield could interfere with sonography. The mechanical safety syringes functioned well in all orthopaedic procedures. Automatic retractable syringes were too small for arthrocentesis of the knee, and the plunger blew out and prematurely collapsed with high-pressure injections. The manual retractable syringes and shielded syringes could be used with conventional needles for most orthopaedic procedures. The most effective and reliable safety devices for orthopaedic syringe procedures are shielded safety needles, mechanical syringes, manual retractable syringes, and shielded syringes, but not automatic retractable syringes. Even when adopting

Orthopaedic training in Kenya

African Journals Online (AJOL)

Background: Orthopaedic training in Kenya, like in other East, central and .... quite a number of good facilities that would train an ... provide a forum for exchange of ideas and training. (2,3) ... administrators purely interested in service provision,.

Radiation safety knowledge and practices among Irish orthopaedic trainees.

LENUS (Irish Health Repository)

Nugent, M

2014-04-23

Fluoroscopy is frequently used in orthopaedic surgery, particularly in a trauma setting. Exposure of patients and staff to ionising radiation has been studied extensively; however, little work has been done to evaluate current knowledge and practices among orthopaedic trainees.

Establishing a children's orthopaedic hospital for Malawi: A review ...

African Journals Online (AJOL)

ordinate the MNCP since 2007. At present the program has a total of 29 clinics, which have treated 5748 patients. Furthermore, BCIH has overseen the full or partial training of 5 orthopaedic surgeons and 82 orthopaedic clinical officers in Malawi.

Planning for life after orthopaedics.

Science.gov (United States)

Barr, Joseph S; McCaslin, Michael J; Hinds, Cynthia K

2014-01-01

The word retirement is going out of fashion. Many orthopaedic surgeons want to work in some capacity when they stop performing surgery. Making a smooth transition from a busy orthopaedic practice to alternative work demands advanced planning. The surgeon must consider personal issues that involve how to use human capital (his or her accumulated knowledge and experience). New ventures, hobbies, travel, and spending time with family and friends are some possibilities. Plans for slowing down or leaving the practice should be discussed and agreed on well ahead of time. Agreements for buyouts may be difficult to work out and will require creative thinking. The solo practitioner can close the practice or hire a successor. Financial planning is perhaps the most important consideration and should be started by approximately age 40. It is recommended that the surgeon develop a portfolio of secure investments and annuities to provide adequate income for as long as is needed and then to turn the residual income to one's family, favorite charities, or other desired cause. A team of competent advisors is needed to help develop and achieve one's goals, create financial security, and provide the discipline to carry out the needed planning for life after orthopaedics.

The efficacy of an extended scope physiotherapy clinic in paediatric orthopaedics.

LENUS (Irish Health Repository)

O Mir, Marie

2016-04-01

The demand for paediatric orthopaedic care is growing, and providing the service required is an increasingly challenging task. Physiotherapist-led triage clinics are utilised in adult orthopaedics to enable the provision of care to patients who may not require a surgical consult. The Physiotherapy Orthopaedic Triage Clinic (POTC) was established in Our Lady\\'s Children\\'s Hospital Crumlin in response to increasing demands on the paediatric orthopaedic service. The clinic is run by physiotherapists working in an advanced practice role (APP), and is the first paediatric clinic of its type and scale in the Republic of Ireland.

Acute and overuse elbow trauma: radio-orthopaedics overview.

Science.gov (United States)

Nocerino, Elisabetta Antonia; Cucchi, Davide; Arrigoni, Paolo; Brioschi, Marco; Fusi, Cristiano; Genovese, Eugenio A; Messina, Carmelo; Randelli, Pietro; Masciocchi, Carlo; Aliprandi, Alberto

2018-01-19

The correct management of acute, subacute and overuse-related elbow pathologies represents a challenging diagnostic and therapeutic problem. While major trauma frequently requires a rapid surgical intervention, subluxation and minor trauma allow taking more time for diagnostics and planning the correct elective treatment after careful clinical and radiological investigation. In these conditions, communication between orthopaedic surgeon and radiologist allow to create a detailed radiology report, tailored to the patient's and surgeon's needs and optimal to plan proper management. Imaging technique as X-Ray, CT, US, MRI, CTA and MRA all belong to the radiologist's portfolio in elbow diagnostics. Detailed knowledge of elbow pathology and its classification and of the possibilities and limits of each imaging technique is of crucial importance to reach the correct diagnosis efficiently. The aim of this review is to present the most frequent elbow pathologies and suggest a suitable diagnostic approach for each of them.

Applications of SSAFT EOS for determination of the solubilities of ...

African Journals Online (AJOL)

Applications of SSAFT EOS for determination of the solubilities of solid compounds in supercritical CO 2 . ... Using statistical thermodynamics such as Simplified SAFT equation of state (SSAFTEoS) for estimating phase equilibrium and fluid properties of different materials have been used widely. SSAFT EoS has been ...

The Placenta: Applications in Orthopaedic Sports Medicine.

Science.gov (United States)

McIntyre, James Alexander; Jones, Ian A; Danilkovich, Alla; Vangsness, C Thomas

2018-01-01

Placenta has a long history of use for treating burns and wounds. It is a rich source of collagen and other extracellular matrix proteins, tissue reparative growth factors, and stem cells, including mesenchymal stem cells (MSCs). Recent data show its therapeutic potential for orthopaedic sports medicine indications. To provide orthopaedic surgeons with an anatomic description of the placenta, to characterize its cellular composition, and to review the literature reporting the use of placenta-derived cells and placental tissue allografts for orthopaedic sports medicine indications in animal models and in humans. Systematic review. Using a total of 63 keyword combinations, the PubMed and MEDLINE databases were searched for published articles describing the use of placental cells and/or tissue for orthopaedic sports medicine indications. Information was collected on placental tissue type, indications, animal model, study design, treatment regimen, safety, and efficacy outcomes. Results were categorized by indication and subcategorized by animal model. Outcomes for 29 animal studies and 6 human studies reporting the use of placenta-derived therapeutics were generally positive; however, the placental tissue source, clinical indication, and administration route were highly variable across these studies. Fourteen animal studies described the use of placental tissue for tendon injuries, 13 studies for osteoarthritis or articular cartilage injuries, 3 for ligament injuries, and 1 for synovitis. Both placenta-derived culture-expanded cells (epithelial cells or MSCs) and placental tissue allografts were used in animal studies. In all human studies, commercial placental allografts were used. Five of 6 human studies examined the treatment of foot and ankle pathological conditions, and 1 studied the treatment of knee osteoarthritis. A review of the small number of reported studies revealed a high degree of variability in placental cell types, placental tissue preparation, routes

New impressive capabilities of SE-workbench for EO/IR real-time rendering of animated scenarios including flares

Science.gov (United States)

Le Goff, Alain; Cathala, Thierry; Latger, Jean

2015-10-01

To provide technical assessments of EO/IR flares and self-protection systems for aircraft, DGA Information superiority resorts to synthetic image generation to model the operational battlefield of an aircraft, as viewed by EO/IR threats. For this purpose, it completed the SE-Workbench suite from OKTAL-SE with functionalities to predict a realistic aircraft IR signature and is yet integrating the real-time EO/IR rendering engine of SE-Workbench called SE-FAST-IR. This engine is a set of physics-based software and libraries that allows preparing and visualizing a 3D scene for the EO/IR domain. It takes advantage of recent advances in GPU computing techniques. The recent past evolutions that have been performed concern mainly the realistic and physical rendering of reflections, the rendering of both radiative and thermal shadows, the use of procedural techniques for the managing and the rendering of very large terrains, the implementation of Image- Based Rendering for dynamic interpolation of plume static signatures and lastly for aircraft the dynamic interpolation of thermal states. The next step is the representation of the spectral, directional, spatial and temporal signature of flares by Lacroix Defense using OKTAL-SE technology. This representation is prepared from experimental data acquired during windblast tests and high speed track tests. It is based on particle system mechanisms to model the different components of a flare. The validation of a flare model will comprise a simulation of real trials and a comparison of simulation outputs to experimental results concerning the flare signature and above all the behavior of the stimulated threat.

Mission operations update for the restructured Earth Observing System (EOS) mission

Science.gov (United States)

Kelly, Angelita Castro; Chang, Edward S.

1993-01-01

The National Aeronautics and Space Administration's (NASA) Earth Observing System (EOS) will provide a comprehensive long term set of observations of the Earth to the Earth science research community. The data will aid in determining global changes caused both naturally and through human interaction. Understanding man's impact on the global environment will allow sound policy decisions to be made to protect our future. EOS is a major component of the Mission to Planet Earth program, which is NASA's contribution to the U.S. Global Change Research Program. EOS consists of numerous instruments on multiple spacecraft and a distributed ground system. The EOS Data and Information System (EOSDIS) is the major ground system developed to support EOS. The EOSDIS will provide EOS spacecraft command and control, data processing, product generation, and data archival and distribution services for EOS spacecraft. Data from EOS instruments on other Earth science missions (e.g., Tropical Rainfall Measuring Mission (TRMM)) will also be processed, distributed, and archived in EOSDIS. The U.S. and various International Partners (IP) (e.g., the European Space Agency (ESA), the Ministry of International Trade and Industry (MITI) of Japan, and the Canadian Space Agency (CSA)) participate in and contribute to the international EOS program. The EOSDIS will also archive processed data from other designated NASA Earth science missions (e.g., UARS) that are under the broad umbrella of Mission to Planet Earth.

Bone Adaptation Around Orthopaedic Implants of Varying Materials

DEFF Research Database (Denmark)

Bagge, Mette

1998-01-01

The bone adaptation around orthopaedic implants is simulated using a three-dimensional finite element model. The remodeling scheme has its origin in optimization methods, and includes anisotropy and time-dependent loading......The bone adaptation around orthopaedic implants is simulated using a three-dimensional finite element model. The remodeling scheme has its origin in optimization methods, and includes anisotropy and time-dependent loading...

Results from the MWA EoR Experiment

Science.gov (United States)

Webster, Rachel L.; MWA EoR Collaboration

2018-05-01

The MWA EoR is one of a small handful of experiments designed to detect the statistical signal from the Epoch of Reionisation. Each of these experiments has reached a level of maturity, where the challenges, in particular of foreground removal, are being more fully understood. Over the past decade, the MWA EoR Collaboration has developed expertise and an understanding of the elements of the telescope array, the end-to-end pipelines, ionospheric conditions, and and the foreground emissions. Sufficient data has been collected to detect the theoretically predicted EoR signal. Limits have been published regularly, however we still several orders of magnitude from a possible detection. This paper outlines recent progress and indicates directions for future efforts.

Supernova constraints on neutrino oscillation and EoS for proto-neutron star

Energy Technology Data Exchange (ETDEWEB)

Kajino, T. [National Astronomical Observatory of Japan, 2-21-1 Osawa, Mitaka, Tokyo 181-8588, Japan and Department of Astronomy, University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-0033 (Japan); Aoki, W. [National Astronomical Observatory of Japan, 2-21-1 Osawa, Mitaka, Tokyo 181-8588 (Japan); Cheoun, M.-K. [Department of Physics, Soongsil University, Seoul 156-743 (Korea, Republic of); Hayakawa, T. [Japan Atomic Energy Agency, Shirakara-Shirane 2-4, Tokai-mura, Ibaraki 319-1195 (Japan); Hidaka, J. [National Astronomical Observatory, 2-21-1 Osawa, Mitaka, Tokyo 181-8588 (Japan); Hirai, Y.; Shibagaki, S. [National Astronomical Observatory, 2-21-1 Osawa, Mitaka, Tokyo 181-8588, Japan and Department of Astronomy, University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-0033 (Japan); Mathews, G. J. [Department of Physics, University of Notre Dame, IN 46556 (United States); Nakamura, K. [Waseda University, Ohkubo 3-4-1, Shinjuku, Tokyo 169-8555 (Japan); Suzuki, T. [Nihon University, Sakurajosui 3-25-40, Setagaya-ku, Tokyo 156-8550 (Japan)

2014-05-02

Core-collapse supernovae eject huge amount of flux of energetic neutrinos which affect explosive nucleosynthesis of rare isotopes like {sup 7}Li, {sup 11}B, {sup 92}Nb, {sup 138}La and Ta and r-process elements. Several isotopes depend strongly on the neutrino flavor oscillation due to the Mikheyev-Smirnov-Wolfenstein (MSW) effect. We here discuss how to determine the neutrino temperatures and propose a method to determine still unknown neutrino oscillation parameters, mass hierarchy and θ{sub 13}, simultaneously. Combining the recent experimental constraints on θ{sub 13} with isotopic ratios of the light elements discovered in presolar grains from the Murchison meteorite, we show that our method suggests at a marginal preference for an inverted neutrino mass hierarchy. We also discuss supernova relic neutrinos that may indicate the softness of the equation of state (EoS) of nuclear matter as well as adiabatic conditions of the neutrino oscillation.

Supernova constraints on neutrino oscillation and EoS for proto-neutron star

Science.gov (United States)

Kajino, T.; Aoki, W.; Cheoun, M.-K.; Hayakawa, T.; Hidaka, J.; Hirai, Y.; Mathews, G. J.; Nakamura, K.; Shibagaki, S.; Suzuki, T.

2014-05-01

Core-collapse supernovae eject huge amount of flux of energetic neutrinos which affect explosive nucleosynthesis of rare isotopes like 7Li, 11B, 92Nb, 138La and Ta and r-process elements. Several isotopes depend strongly on the neutrino flavor oscillation due to the Mikheyev-Smirnov-Wolfenstein (MSW) effect. We here discuss how to determine the neutrino temperatures and propose a method to determine still unknown neutrino oscillation parameters, mass hierarchy and θ13, simultaneously. Combining the recent experimental constraints on θ13 with isotopic ratios of the light elements discovered in presolar grains from the Murchison meteorite, we show that our method suggests at a marginal preference for an inverted neutrino mass hierarchy. We also discuss supernova relic neutrinos that may indicate the softness of the equation of state (EoS) of nuclear matter as well as adiabatic conditions of the neutrino oscillation.

Prevalence and pattern of small animal orthopaedic conditions at ...

African Journals Online (AJOL)

Small animal orthopaedic case records of a 20-year period were surveyed to obtain the prevalence and pattern of orthopaedic conditions presented to the Veterinary Teaching Hospital (VTH), University of Ibadan, Nigeria, with the objective of providing data for planning on small animal healthcare facilities, policy ...

EOS microdose protocol for the radiological follow-up of adolescent idiopathic scoliosis.

Science.gov (United States)

Ilharreborde, Brice; Ferrero, Emmanuelle; Alison, Marianne; Mazda, Keyvan

2016-02-01

Imaging plays a key role in adolescent idiopathic scoliosis (AIS) to determine the prognosis and accordingly define the best therapeutic strategy to follow. Conventional radiographs with ionizing radiation have been associated with 1-2 % increased lifetime risk of developing cancer in children, and physicians, therefore, need a sensitive but harmless way to explore patients at risk, according to the "as low as reasonably achievable" concept. The EOS system (EOS imaging, Paris, France) is available in routine clinical use since 2007, and allows 3D reconstructions of the trunk in standing position with significant radiation reduction. With recent technical advances, further dose reduction can be obtained, but at the cost of image quality that might alter the reliability of 3D reconstructions. The aim of the present study was to analyze the reproducibility of a "microdose" protocol, and evaluate its use in clinical practice. 32 consecutive patients followed for AIS were prospectively included. Biplanar radiographs were obtained with the EOS system according to the new microdose protocol. From the microdose images obtained, three experienced operators performed 3D reconstructions, two times for each subject in a random order (total, 192 reconstructions). The intraoperator repeatability and interoperator reproducibility were evaluated, as recommended by the International Organization for Standardization, for the most clinically relevant 3D radiological parameters. The identification of the required anatomical landmarks for the "fast spine" reconstruction process was possible in all cases. None of the patients required a second acquisition for 3D analysis. Mean time for reconstruction was 5 ± 2 min. The intraoperator repeatability was better than interoperator reproducibility for all parameters, with values ranging between 3° and 8° for frontal and sagittal spinal parameters, and between 1° and 8° for pelvic measurements. The agreement was very good for all clinical

Orthopaedic surgeries - assessment of ionising radiations exposure in health care workers

International Nuclear Information System (INIS)

Leite, E.S.; Uva, A.S.

2006-01-01

Full text of publication follows: 1. Objectives: The health care workers are exposed to ionizing radiations during their activities. In the operating rooms, the ionizing radiations are used in orthopaedic surgery and the dose depends on some factors, like the characteristics of the equipment. This study aims to: Estimate the occupational dose of ionizing radiations exposure of the orthopaedic doctors and nurses during the orthopaedic surgeries, in a Portuguese operating room; Sensitize the health care workers to use the individual dosimeter and to adopt radiation preventive measures. 2. Population and methods The study was conducted on nine Orthopaedic doctors and two nurses of an operating room of a hospital in Lisbon neighborhoods. We made a risk evaluating concerning: the radiations dose in different points, corresponding to gonads, hands and crystalline lens levels of all the professionals, during the surgeries; the average period of radiation in the orthopaedic surgeries; the number of annual orthopaedic surgeries, looking for that in the surgeries registers, to estimate the annual ionizing radiations dose of each orthopaedic doctor and nurse. 3. Results The annual doses estimated at different levels for orthopaedic doctors were the following: gonads: between 20,63 and 68,75 mGy; hands: 4,95 16,50 mGy; crystalline lens: 8,25 27,50 mGy). For the orthopaedic nurses: gonads: 130,63 151,25 mGy; hands: 31,35 36,30 mGy; crystalline lens 52,25 60,25 mGy. 4. Conclusions Although the location and positions of health care workers are not the same during the different surgeries and the equipment has an automatic control of the X ray emission, the annual ionizing radiations dose exposure for health care workers is an important one. The risk rating justifies the use of individual dosimeters for better individual dose assessment as part of an ionizing radiations prevention program. As a matter of fact preventive measures begin with a good quantitative risk assessment of

Radiometric cross-calibration of EO-1 ALI with L7 ETM+ and Terra MODIS sensors using near-simultaneous desert observations

Science.gov (United States)

Chander, Gyanesh; Angal, Amit; Choi, Taeyoung; Xiong, Xiaoxiong

2013-01-01

The Earth Observing-1 (EO-1) satellite was launched on November 21, 2000, as part of a one-year technology demonstration mission. The mission was extended because of the value it continued to add to the scientific community. EO-1 has now been operational for more than a decade, providing both multispectral and hyperspectral measurements. As part of the EO-1 mission, the Advanced Land Imager (ALI) sensor demonstrates a potential technological direction for the next generation of Landsat sensors. To evaluate the ALI sensor capabilities as a precursor to the Operational Land Imager (OLI) onboard the Landsat Data Continuity Mission (LDCM, or Landsat 8 after launch), its measured top-of-atmosphere (TOA) reflectances were compared to the well-calibrated Landsat 7 (L7) Enhanced Thematic Mapper Plus (ETM+) and the Terra Moderate Resolution Imaging Spectroradiometer (MODIS) sensors in the reflective solar bands (RSB). These three satellites operate in a near-polar, sun-synchronous orbit 705 km above the Earth's surface. EO-1 was designed to fly one minute behind L7 and approximately 30 minutes in front of Terra. In this configuration, all the three sensors can view near-identical ground targets with similar atmospheric, solar, and viewing conditions. However, because of the differences in the relative spectral response (RSR), the measured physical quantities can be significantly different while observing the same target. The cross-calibration of ALI with ETM+ and MODIS was performed using near-simultaneous surface observations based on image statistics from areas observed by these sensors over four desert sites (Libya 4, Mauritania 2, Arabia 1, and Sudan 1). The differences in the measured TOA reflectances due to RSR mismatches were compensated by using a spectral band adjustment factor (SBAF), which takes into account the spectral profile of the target and the RSR of each sensor. For this study, the spectral profile of the target comes from the near-simultaneous EO-1

SenSyF Experience on Integration of EO Services in a Generic, Cloud-Based EO Exploitation Platform

Science.gov (United States)

Almeida, Nuno; Catarino, Nuno; Gutierrez, Antonio; Grosso, Nuno; Andrade, Joao; Caumont, Herve; Goncalves, Pedro; Villa, Guillermo; Mangin, Antoine; Serra, Romain; Johnsen, Harald; Grydeland, Tom; Emsley, Stephen; Jauch, Eduardo; Moreno, Jose; Ruiz, Antonio

2016-08-01

SenSyF is a cloud-based data processing framework for EO- based services. It has been pioneer in addressing Big Data issues from the Earth Observation point of view, and is a precursor of several of the technologies and methodologies that will be deployed in ESA's Thematic Exploitation Platforms and other related systems.The SenSyF system focuses on developing fully automated data management, together with access to a processing and exploitation framework, including Earth Observation specific tools. SenSyF is both a development and validation platform for data intensive applications using Earth Observation data. With SenSyF, scientific, institutional or commercial institutions developing EO- based applications and services can take advantage of distributed computational and storage resources, tailored for applications dependent on big Earth Observation data, and without resorting to deep infrastructure and technological investments.This paper describes the integration process and the experience gathered from different EO Service providers during the project.

Energy Referencing in LANL HE-EOS Codes

Energy Technology Data Exchange (ETDEWEB)

Leiding, Jeffery Allen [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Coe, Joshua Damon [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2017-10-19

Here, We briefly describe the choice of energy referencing in LANL's HE-EOS codes, HEOS and MAGPIE. Understanding this is essential to comparing energies produced by different EOS codes, as well as to the correct calculation of shock Hugoniots of HEs and other materials. In all equations after (3) throughout this report, all energies, enthalpies and volumes are assumed to be molar quantities.

Ireland's contribution to orthopaedic literature: a bibliometric analysis.

Science.gov (United States)

Kennedy, C; O Sullivan, P; Bilal, M; Walsh, A

2013-10-01

Bibliometric analysis of scientific performance within a country or speciality, facilitate the recognition of factors that may further enhance research activity and performance. Our aim was to illicit the current state of Irelands orthopaedic research output in terms of quantity and quality. We performed a retrospective bibliometric analysis of all Irish orthopaedic publications over the past 5 years, in the top 20 peer-reviewed orthopaedic journals. Utilising the MEDLINE database, each journal was evaluated for articles that were published over the study period. Reviews, editorials, reports and letters were excluded. Each article abstract was analysed for research content, and country of origin. A nation's mean IF was defined by multiplying each journal's IF by the number of articles. Publications per million (PmP) was calculated by dividing the total number of publications by the population of each country. We analysed a total of 25,595 article abstracts. Ireland contributed 109 articles in total (0.42% of all articles), however ranking according to population per million was 10th worldwide. Ireland ranked 18th worldwide in relation to mean impact factor, which was 2.91 over the study period. Ireland published in 16 of the top 20 journals, 9 of these were of European origin, and 1 of the top 5 was of American origin. In total, 61 Irish articles were assignable to clinical orthopaedic units. Clinical based studies (randomised controlled trials, observational, and epidemiology/bibliometric articles) and research based studies (In vivo, In vitro, and biomechanical) numbered 76 (69.7%) and 33 (30.2%) articles, respectively. This study provides a novel overview of current Irish orthopaedic related research, and how our standards translate to the worldwide orthopaedic community. In order to maintain our publication productivity, academic research should continue to be encouraged at post graduate level. Copyright © 2013 Royal College of Surgeons of Edinburgh

76 FR 70927 - USACE's Plan for Retrospective Review Under E.O. 13563

Science.gov (United States)

2011-11-16

... for Retrospective Review Under E.O. 13563 AGENCY: U.S. Army Corps of Engineers, DoD. ACTION: Notice of...'' (E.O.), issued on January 18, 2011, directs Federal agencies to review existing significant... they are a significant rule warranting review pursuant to E.O. 13563. The E.O. further directs each...

Are the claims made in orthopaedic print advertisements valid?

Science.gov (United States)

Davidson, Donald J; Rankin, Kenneth S; Jensen, Cyrus D; Moverley, Robert; Reed, Mike R; Sprowson, Andrew P

2014-05-01

Advertisements are commonplace in orthopaedic journals and may influence the readership with claims of clinical and scientific fact. Since the last assessment of the claims made in orthopaedic print advertisements ten years ago, there have been legislative changes and media scrutiny which have shaped this practice. The purpose of this study is to re-evaluate these claims. Fifty claims from 50 advertisements were chosen randomly from six highly respected peer-reviewed orthopaedic journals (published July-December 2011). The evidence supporting each claim was assessed and validated by three orthopaedic surgeons. The assessors, blinded to product and company, rated the evidence and answered the following questions: Does the evidence as presented support the claim made in the advertisement and what is the quality of that evidence? Is the claim supported by enough evidence to influence your own clinical practice? Twenty-eight claims cited evidence from published literature, four from public presentations, 11 from manufacturer "data held on file" and seven had no supporting evidence. Only 12 claims were considered to have high-quality evidence and only 11 were considered well supported. A strong correlation was seen between the quality of evidence and strength of support (Spearman r = 0.945, p advertisements. High-quality evidence is required by orthopaedic surgeons to influence clinical practice and this evidence should be sought by manufacturers wishing to market a successful product.

Is There Value in Having Radiology Provide a Second Reading in Pediatric Orthopaedic Clinic?

Science.gov (United States)

Natarajan, Vivek; Bosch, Patrick; Dede, Ozgur; Deeney, Vincent; Mendelson, Stephen; Ward, Timothy; Brooks, Maria; Kenkre, Tanya; Roach, James

2017-06-01

The Joint Commission on Accreditation of Healthcare Organizations specifically mandates the dual interpretation of musculoskeletal radiographs by a radiologist in addition to the orthopaedist in all hospital-based orthopaedic clinics. Previous studies have questioned the utility of this practice. The purpose of this study was to further investigate the clinical significance of having the radiologist provide a second interpretation in a hospital-based pediatric orthopaedic clinic. A retrospective review was performed of all patients who had plain radiographs obtained in the pediatric orthopaedic clinic at an academic children's hospital over a 4-month period. For each radiographic series, the orthopaedist's note and the radiology interpretation were reviewed and a determination was made of whether the radiology read provided new clinically useful information and/or a new diagnosis, whether it recommended further imaging, or if it missed a diagnosis that was reflected in the orthopaedist's note. The hospital charges associated with the radiology read for each study were also quantified. The charts of 1570 consecutive clinic patients who were seen in the pediatric orthopaedic clinic from January to April, 2012 were reviewed. There were 2509 radiographic studies performed, of which 2264 had both a documented orthopaedist's note and radiologist's read. The radiologist's interpretation added new, clinically important information in 1.0% (23/2264) of these studies. In 1.7% (38/2264) of the studies, it was determined that the radiologist missed the diagnosis or clinically important information that could affect treatment. The total amount of the professional fees charged for the radiologists' interpretations was $87,362. On average, the hospital charges for each occurrence in which the radiologist's read provided an additional diagnosis or clinically important information beyond the orthopaedist's note were $3798. The results of this study suggest that eliminating the

Patient Perspectives of Midlevel Providers in Orthopaedic Sports Medicine.

Science.gov (United States)

Manning, Blaine T; Bohl, Daniel D; Hannon, Charles P; Redondo, Michael L; Christian, David R; Forsythe, Brian; Nho, Shane J; Bach, Bernard R

2018-04-01

Midlevel providers (eg, nurse practitioners and physician assistants) have been integrated into orthopaedic systems of care in response to the increasing demand for musculoskeletal care. Few studies have examined patient perspectives toward midlevel providers in orthopaedic sports medicine. To identify perspectives of orthopaedic sports medicine patients regarding midlevel providers, including optimal scope of practice, reimbursement equity with physicians, and importance of the physician's midlevel provider to patients when initially selecting a physician. Cross-sectional study; Level of evidence, 3. A total of 690 consecutive new patients of 3 orthopaedic sports medicine physicians were prospectively administered an anonymous questionnaire prior to their first visit. Content included patient perspectives regarding midlevel provider importance in physician selection, optimal scope of practice, and reimbursement equity with physicians. Of the 690 consecutive patients who were administered the survey, 605 (87.7%) responded. Of these, 51.9% were men and 48.1% were women, with a mean age of 40.5 ± 15.7 years. More than half (51.2%) perceived no differences in training levels between physician assistants and nurse practitioners. A majority of patients (62.9%) reported that the physician's midlevel provider is an important consideration when choosing a new orthopaedic sports medicine physician. Patients had specific preferences regarding which services should be physician provided. Patients also reported specific preferences regarding those services that could be midlevel provided. There lacked a consensus on reimbursement equity for midlevel practitioners and physicians, despite 71.7% of patients responding that the physician provides a higher-quality consultation. As health care becomes value driven and consumer-centric, understanding patient perspectives on midlevel providers will allow orthopaedic sports medicine physicians to optimize efficiency and patient

The 25 most cited articles in arthroscopic orthopaedic surgery.

Science.gov (United States)

Cassar Gheiti, Adrian J; Downey, Richard E; Byrne, Damien P; Molony, Diarmuid C; Mulhall, Kevin J

2012-04-01

The purpose of this study was to use Web of Knowledge to determine which published arthroscopic surgery-related articles have been cited most frequently by other authors by ranking the 25 most cited articles. We furthermore wished to determine whether there is any difference between a categorical "journal-by-journal" analysis and an "all-database" analysis in arthroscopic surgery and whether such a search methodology would alter the results of previously published lists of "citation classics" in the field. We analyzed the characteristics of these articles to determine what qualities make an article important to this subspecialty of orthopaedic surgery. Web of Knowledge was searched on March 7, 2011, using the term "arthroscopy" for citations to articles related to arthroscopy in 61 orthopaedic journals and using the all-database function. Each of the 61 orthopaedic journals was searched separately for arthroscopy-related articles to determine the 25 most cited articles. An all-database search for arthroscopy-related articles was carried out and compared with a journal-by-journal search. Each article was reviewed for basic information including the type of article, authorship, institution, country, publishing journal, and year published. The number of citations ranged from 189 to 567 in a journal-by-journal search and from 214 to 1,869 in an all-database search. The 25 most cited articles on arthroscopic surgery were published in 11 journals: 8 orthopaedic journals and 3 journals from other specialties. The most cited article in arthroscopic orthopaedic surgery was published in The New England Journal of Medicine, which was not previously identified by a journal-by-journal search. An all-database search in Web of Knowledge gives a more in-depth methodology of determining the true citation ranking of articles. Among the top 25 most cited articles, autologous chondrocyte implantation/transplantation is currently the most cited and most popular topic in arthroscopic

Rigorous theoretical constraint on constant negative EoS parameter [Formula: see text] and its effect for the late Universe.

Science.gov (United States)

Burgazli, Alvina; Eingorn, Maxim; Zhuk, Alexander

In this paper, we consider the Universe at the late stage of its evolution and deep inside the cell of uniformity. At these scales, the Universe is filled with inhomogeneously distributed discrete structures (galaxies, groups and clusters of galaxies). Supposing that the Universe contains also the cosmological constant and a perfect fluid with a negative constant equation of state (EoS) parameter [Formula: see text] (e.g., quintessence, phantom or frustrated network of topological defects), we investigate scalar perturbations of the Friedmann-Robertson-Walker metrics due to inhomogeneities. Our analysis shows that, to be compatible with the theory of scalar perturbations, this perfect fluid, first, should be clustered and, second, should have the EoS parameter [Formula: see text]. In particular, this value corresponds to the frustrated network of cosmic strings. Therefore, the frustrated network of domain walls with [Formula: see text] is ruled out. A perfect fluid with [Formula: see text] neither accelerates nor decelerates the Universe. We also obtain the equation for the nonrelativistic gravitational potential created by a system of inhomogeneities. Due to the perfect fluid with [Formula: see text], the physically reasonable solutions take place for flat, open and closed Universes. This perfect fluid is concentrated around the inhomogeneities and results in screening of the gravitational potential.

IMAGING THE EPOCH OF REIONIZATION: LIMITATIONS FROM FOREGROUND CONFUSION AND IMAGING ALGORITHMS

International Nuclear Information System (INIS)

Vedantham, Harish; Udaya Shankar, N.; Subrahmanyan, Ravi

2012-01-01

Tomography of redshifted 21 cm transition from neutral hydrogen using Fourier synthesis telescopes is a promising tool to study the Epoch of Reionization (EoR). Limiting the confusion from Galactic and extragalactic foregrounds is critical to the success of these telescopes. The instrumental response or the point-spread function (PSF) of such telescopes is inherently three dimensional with frequency mapping to the line-of-sight (LOS) distance. EoR signals will necessarily have to be detected in data where continuum confusion persists; therefore, it is important that the PSF has acceptable frequency structure so that the residual foreground does not confuse the EoR signature. This paper aims to understand the three-dimensional PSF and foreground contamination in the same framework. We develop a formalism to estimate the foreground contamination along frequency, or equivalently LOS dimension, and establish a relationship between foreground contamination in the image plane and visibility weights on the Fourier plane. We identify two dominant sources of LOS foreground contamination—'PSF contamination' and 'gridding contamination'. We show that PSF contamination is localized in LOS wavenumber space, beyond which there potentially exists an 'EoR window' with negligible foreground contamination where we may focus our efforts to detect EoR. PSF contamination in this window may be substantially reduced by judicious choice of a frequency window function. Gridding and imaging algorithms create additional gridding contamination and we propose a new imaging algorithm using the Chirp Z Transform that significantly reduces this contamination. Finally, we demonstrate the analytical relationships and the merit of the new imaging algorithm for the case of imaging with the Murchison Widefield Array.

The use of three-dimensional printing technology in orthopaedic surgery.

Science.gov (United States)

Wong, Tak Man; Jin, Jimmy; Lau, Tak Wing; Fang, Christian; Yan, Chun Hoi; Yeung, Kelvin; To, Michael; Leung, Frankie

2017-01-01

Three-dimensional (3-D) printing or additive manufacturing, an advanced technology that 3-D physical models are created, has been wildly applied in medical industries, including cardiothoracic surgery, cranio-maxillo-facial surgery and orthopaedic surgery. The physical models made by 3-D printing technology give surgeons a realistic impression of complex structures, allowing surgical planning and simulation before operations. In orthopaedic surgery, this technique is mainly applied in surgical planning especially revision and reconstructive surgeries, making patient-specific instruments or implants, and bone tissue engineering. This article reviews this technology and its application in orthopaedic surgery.

Diabetic mouse model of orthopaedic implant-related Staphylococcus aureus infection.

Science.gov (United States)

Lovati, Arianna B; Drago, Lorenzo; Monti, Lorenzo; De Vecchi, Elena; Previdi, Sara; Banfi, Giuseppe; Romanò, Carlo L

2013-01-01

Periprosthetic bacterial infections represent one of the most challenging orthopaedic complications that often require implant removal and surgical debridement and carry high social and economical costs. Diabetes is one of the most relevant risk factors of implant-related infection and its clinical occurrence is growing worldwide. The aim of the present study was to test a model of implant-related infection in the diabetic mouse, with a view to allow further investigation on the relative efficacy of prevention and treatment options in diabetic and non-diabetic individuals. A cohort of diabetic NOD/ShiLtJ mice was compared with non-diabetic CD1 mice as an in vivo model of S. aureus orthopaedic infection of bone and soft tissues after femur intramedullary pin implantation. We tested control and infected groups with 1×10(3) colony-forming units of S. aureus ATCC 25923 strain injected in the implant site. At 4 weeks post-inoculation, host response to infection, microbial biofilm formation, and bone damage were assessed by traditional diagnostic parameters (bacterial culture, C-reactive protein and white blood cell count), histological analysis and imaging techniques (micro computed tomography and scanning electron microscopy). Unlike the controls and the CD1 mice, all the diabetic mice challenged with a single inoculum of S. aureus displayed severe osteomyelitic changes around the implant. Our findings demonstrate for the first time that the diabetic mouse can be successfully used in a model of orthopaedic implant-related infection. Furthermore, the same bacteria inoculum induced periprosthetic infection in all the diabetic mice but not in the controls. This animal model of implant-related infection in diabetes may be a useful tool to test in vivo treatments in diabetic and non-diabetic individuals.

Diabetic mouse model of orthopaedic implant-related Staphylococcus aureus infection.

Directory of Open Access Journals (Sweden)

Arianna B Lovati

Full Text Available BACKGROUND: Periprosthetic bacterial infections represent one of the most challenging orthopaedic complications that often require implant removal and surgical debridement and carry high social and economical costs. Diabetes is one of the most relevant risk factors of implant-related infection and its clinical occurrence is growing worldwide. The aim of the present study was to test a model of implant-related infection in the diabetic mouse, with a view to allow further investigation on the relative efficacy of prevention and treatment options in diabetic and non-diabetic individuals. METHODOLOGY: A cohort of diabetic NOD/ShiLtJ mice was compared with non-diabetic CD1 mice as an in vivo model of S. aureus orthopaedic infection of bone and soft tissues after femur intramedullary pin implantation. We tested control and infected groups with 1×10(3 colony-forming units of S. aureus ATCC 25923 strain injected in the implant site. At 4 weeks post-inoculation, host response to infection, microbial biofilm formation, and bone damage were assessed by traditional diagnostic parameters (bacterial culture, C-reactive protein and white blood cell count, histological analysis and imaging techniques (micro computed tomography and scanning electron microscopy. RESULTS: Unlike the controls and the CD1 mice, all the diabetic mice challenged with a single inoculum of S. aureus displayed severe osteomyelitic changes around the implant. CONCLUSIONS: Our findings demonstrate for the first time that the diabetic mouse can be successfully used in a model of orthopaedic implant-related infection. Furthermore, the same bacteria inoculum induced periprosthetic infection in all the diabetic mice but not in the controls. This animal model of implant-related infection in diabetes may be a useful tool to test in vivo treatments in diabetic and non-diabetic individuals.

Orthopaedic Rehabilitation Device Actuated with Pneumatic Muscles

Directory of Open Access Journals (Sweden)

Ioana Petre

2014-07-01

Full Text Available Year after year recovery clinics worldwide report significant numbers of lower limb bearing joint disabilities. An effective method for the speedy rehabilitation of patients with such afflictions is Continuous Passive Motion (CPM, drawing upon a range of specific equipment. This paper presents an innovative constructive solution for such orthopaedic rehabilitation equipment, designed to ensure a swift reintegration of patients at as low a cost as possible. The absolute novelty consists in the utilization of the linear pneumatic muscle as actuator of the orthopaedic rehabilitation equipment, thus achieving a light and highly compliant construction that satisfies safety requirements related to man-machine interaction. Pneumatic muscles are bio-inspired actuation systems characterized by a passive variable compliant behaviour. This property, deployed in rehabilitation systems, enables the development of human friendly devices, which are comfortable for the patients, and capable of safe interaction. This paper presents the constructive schematic of the orthopaedic rehabilitation equipment, the structure of the actuation and positioning system, and several of its functional characteristics.

OMPS Near Real-time Products Available Through NASA LANCE (Land Atmosphere Near Real-time Capability for EOS)

Science.gov (United States)

Warnock, A.; Durbin, P. B.; Cechini, M. F.; Masuoka, E.

2017-12-01

Near real-time (NRT) images from the NASA Ozone Mapping and Profiler Suite (OMPS) for sulfur dioxide, total column ozone and aerosol index products are now available through NASA's online Land Atmosphere Near real-time Capability for EOS (LANCE) system. Color palettes, image dimensions and data ranges have been aligned with the corresponding OMI products, allowing for direct comparison of OMPS NRT images with OMI NRT images already available in NASA Worldview. The images are delivered to LANCE within hours of satellite observation. LANCE NRT imagery can be interactively viewed through Worldview and the Global Imagery Browse Services (GIBS).

Earth Observation for Biodiversity Assessment (EO-BA)

CSIR Research Space (South Africa)

Cho, Moses A

2012-10-01

Full Text Available in the Dukuduku coastal forest Earth Observation for Biodiversity Assessment (EO-BA) MA CHO, P DEBBA, R MATHIEU, A RAMOELO, L NAIDOO, H VAN DEVENTER, O MALAHLELA AND R MAIN CSIR Natural Resources and the Environment, Pretoria, South Africa PO Box 395... Observation for Biodiversity Assessment (EO-BA) programme is designed to enhance biodiversity assessment and conservation through the application of earth observation data, with particular focus on the African continent. MISSION To initiate and develop...

Open access publishing: a study of current practices in orthopaedic research.

Science.gov (United States)

Sabharwal, Sanjeeve; Patel, Nirav; Johal, Karanjeev

2014-06-01

Open access (OA) publications have changed the paradigm of dissemination of scientific research. Their benefits to low-income countries underline their value; however, critics question exorbitant publication fees as well as their effect on the peer review process and research quality. This study reports on the prevalence of OA publishing in orthopaedic research and compares benchmark citation indices as well as evidence quality derived from OA journals with conventional subscription based orthopaedic journals. All 63 orthopaedic journals listed in ISI's Web of Knowledge Journal Citation Report (JCR) were examined. Bibliometric data attributed to each journal for the year 2012 was acquired from the JCR. Studies that fulfilled the criteria of level I evidence were identified for each journal within PubMed. Individual journal websites were reviewed to identify their open access policy. A total of 38 (60.3 %) journals did not offer any form of OA publishing; however, 20 (31.7 %) hybrid journals were identified which offered authors the choice to publish their work as OA if a publication fee was paid. Only five (8 %) journals published all their articles as OA. There was variability amongst the different publication fees for OA articles. Journals that published OA articles did not differ from subscription based journals on the basis of 2012 impact factor, citation number, self citation proportion or the volume of level I evidence published (p > 0.05). OA journals are present in orthopaedic research, though in small numbers. Over a third of orthopaedic journals catalogued in the ISI Web of Knowledge JCR® are hybrid journals that provide authors with the opportunity to publish their articles as OA after a publication fee is paid. This study suggests equivalent importance and quality of articles between OA and subscription based orthopaedic journals based on bibliometric data and the volume of level I evidence produced. Orthopaedic researchers must recognize the

Orthopaedic Trauma Care Capacity Assessment and Strategic Planning in Ghana: Mapping a Way Forward.

Science.gov (United States)

Stewart, Barclay T; Gyedu, Adam; Tansley, Gavin; Yeboah, Dominic; Amponsah-Manu, Forster; Mock, Charles; Labi-Addo, Wilfred; Quansah, Robert

2016-12-07

Orthopaedic conditions incur more than 52 million disability-adjusted life years annually worldwide. This burden disproportionately affects low and middle-income countries, which are least equipped to provide orthopaedic care. We aimed to assess orthopaedic capacity in Ghana, describe spatial access to orthopaedic care, and identify hospitals that would most improve access to care if their capacity was improved. Seventeen perioperative and orthopaedic trauma care-related items were selected from the World Health Organization's Guidelines for Essential Trauma Care. Direct inspection and structured interviews with hospital staff were used to assess resource availability and factors contributing to deficiencies at 40 purposively sampled facilities. Cost-distance analyses described population-level spatial access to orthopaedic trauma care. Facilities for targeted capability improvement were identified through location-allocation modeling. Orthopaedic trauma care assessment demonstrated marked deficiencies. Some deficient resources were low cost (e.g., spinal immobilization, closed reduction capabilities, and prosthetics for amputees). Resource nonavailability resulted from several contributing factors (e.g., absence of equipment, technology breakage, lack of training). Implants were commonly prohibitively expensive. Building basic orthopaedic care capacity at 15 hospitals without such capacity would improve spatial access to basic care from 74.9% to 83.0% of the population (uncertainty interval [UI] of 81.2% to 83.6%), providing access for an additional 2,169,714 Ghanaians. The availability of several low-cost resources could be better supplied by improvements in organization and training for orthopaedic trauma care. There is a critical need to advocate and provide funding for orthopaedic resources. These initiatives might be particularly effective if aimed at hospitals that could provide care to a large proportion of the population.

Smartphones in orthopaedics

OpenAIRE

Al-Hadithy, Nawfal; Gikas, Panagiotis D; Al-Nammari, Shafic Said

2012-01-01

With the introduction of the European Working Time Directive, surgical trainees are facing limited training opportunities and doctors are required to maximise their training opportunities. Smartphone sales have been rapidly increasing over the last five years and can be used as a training tool for the orthopaedic trainee and surgeon. Common uses include applications (AO, eLogbook and PubMed), Ebooks, online Logbooks, Guidelines and surgical techniques. In addition, smartphones can be used to ...

Maximizing the use of EO products: how to leverage the potential of open geospatial service architectures

Science.gov (United States)

Usländer, Thomas

2012-10-01

The demand for the rapid provision of EO products with well-defined characteristics in terms of temporal, spatial, image-specific and thematic criteria is increasing. Examples are products to support near real-time damage assessment after a natural disaster event, e.g. an earthquake. However, beyond the organizational and economic questions, there are technological and systemic barriers to enable a comfortable search, order, delivery or even combination of EO products. Most portals of space agencies and EO product providers require sophisticated satellite and product knowledge and, even worse, are all different and not interoperable. This paper gives an overview about the use cases and the architectural solutions that aim at an open and flexible EO mission infrastructure with application-oriented user interfaces and well-defined service interfaces based upon open standards. It presents corresponding international initiatives such as INSPIRE (Infrastructure for Spatial Information in the European Community), GMES (Global Monitoring for Environment and Security), GEOSS (Global Earth Observation System of Systems) and HMA (Heterogeneous Missions Accessibility) and their associated infrastructure approaches. The paper presents a corresponding analysis and design methodology and two examples how such architectures are already successfully used in early warning systems for geo-hazards and toolsets for environmentallyinduced health risks. Finally, the paper concludes with an outlook how these ideas relate to the vision of the Future Internet.

Management of Patients with Orthopaedic Implants Undergoing Dental Procedures.

Science.gov (United States)

Quinn, Robert H; Murray, Jayson N; Pezold, Ryan; Sevarino, Kaitlyn S

2017-07-01

The American Academy of Orthopaedic Surgeons, in collaboration with the American Dental Association, has developed Appropriate Use Criteria (AUC) for the Management of Patients with Orthopaedic Implants Undergoing Dental Procedures. Evidence-based information, in conjunction with the clinical expertise of physicians, was used to develop the criteria to improve patient care and obtain best outcomes while considering the subtleties and distinctions necessary in making clinical decisions. The Management of Patients with Orthopaedic Implants Undergoing Dental Procedures AUC clinical patient scenarios were derived from indications of patients with orthopaedic implants presenting for dental procedures, as well as from current evidence-based clinical practice guidelines and supporting literature to identify the appropriateness of the use of prophylactic antibiotics. The 64 patient scenarios and 1 treatment were developed by the writing panel, a group of clinicians who are specialists in this AUC topic. Next, a separate, multidisciplinary, voting panel (made up of specialists and nonspecialists) rated the appropriateness of treatment of each patient scenario using a 9-point scale to designate a treatment as Appropriate (median rating, 7 to 9), May Be Appropriate (median rating, 4 to 6), or Rarely Appropriate (median rating, 1 to 3).

[Famous figures of the Poznań orthopaedics of the period of the occupation and post-war years. Coryphees of Polish orthopaedics].

Science.gov (United States)

Barcikowski, Władysław

2008-01-01

In this article author presents, from a perspective of own memories is portraying persons which he met in his professional activity. They participated in forming the orthopaedics in Poznań and different nooks of Poland. He resembles their, often very dramatic, fates and the influence they had on Polish medicine reviving after the II world war. With the special attention he is reminding one of most well-known and valued celebrities of the Polish orthopaedics professor Wiktor Dega.

Femoral anteversion assessment: Comparison of physical examination, gait analysis, and EOS biplanar radiography.

Science.gov (United States)

Westberry, David E; Wack, Linda I; Davis, Roy B; Hardin, James W

2018-05-01

Multiple measurement methods are available to assess transverse plane alignment of the lower extremity. This study was performed to determine the extent of correlation between femoral anteversion assessment using simultaneous biplanar radiographs and three-dimensional modeling (EOS imaging), clinical hip rotation by physical examination, and dynamic hip rotation assessed by gait analysis. Seventy-seven patients with cerebral palsy (GMFCS Level I and II) and 33 neurologically typical children with torsional abnormalities completed a comprehensive gait analysis with same day biplanar anterior-posterior and lateral radiographs and three-dimensional transverse plane assessment of femoral anteversion. Correlations were determined between physical exam of hip rotation, EOS imaging of femoral anteversion, and transverse plane hip kinematics for this retrospective review study. Linear regression analysis revealed a weak relationship between physical examination measures of hip rotation and biplanar radiographic assessment of femoral anteversion. Similarly, poor correlation was found between clinical evaluation of femoral anteversion and motion assessment of dynamic hip rotation. Correlations were better in neurologically typical children with torsional abnormalities compared to children with gait dysfunction secondary to cerebral palsy. Dynamic hip rotation cannot be predicted by physical examination measures of hip range of motion or from three-dimensional assessment of femoral anteversion derived from biplanar radiographs. Copyright © 2018 Elsevier B.V. All rights reserved.

Social Competence and Temperament in Children with Chronic Orthopaedic Disability

Science.gov (United States)

Yagmurlu, Bilge; Yavuz, H. Melis

2015-01-01

The aim of the study was to investigate social competence in children with orthopaedic disability and its concurrent relations to child's temperament, health condition, and maternal warmth. Participants were 68 Turkish children (mean = 5.94 years) with chronic orthopaedic disability and their mothers coming from disadvantaged backgrounds. Mother…

Battlefield-Acquired Immunogenicity to Metals Affects Orthopaedic Implant Outcome

Science.gov (United States)

2015-10-01

Award Number: W81XWH-10-2-0138 TITLE: Battlefield-Acquired Immunogenicity to Metals Affects Orthopaedic Implant Outcome PRINCIPAL INVESTIGATOR...Immunogenicity to Metals Affects Orthopaedic pla t Outcome 5b. GRANT NUMBER W91ZSQ0135N646 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Nadim James...DISTRIBUTION / AVAILABILITY STATEMENT Approved for public release; distribution unlimited 13. SUPPLEM ENTARY NOTES 14. ABSTRACT The effects of battlefield

Orthopaedic Patient Information on the World Wide Web: An Essential Review.

Science.gov (United States)

Cassidy, John Tristan; Baker, Joseph F

2016-02-17

Patients increasingly use the Internet to research health-related issues. Internet content, unlike other forms of media, is not regulated. Although information accessed online can impact patients' opinions and expectations, there is limited information about the quality or readability of online orthopaedic information. PubMed, MEDLINE, and Google Scholar were searched using anatomic descriptors and three title keywords ("Internet," "web," and "online"). Articles examining online orthopaedic information from January 1, 2000, until April 1, 2015, were recorded. Articles were assessed for the number of reviewers evaluating the online material, whether the article examined for a link between authorship and quality, and the use of recognized quality and readability assessment tools. To facilitate a contemporary discussion, only publications since January 1, 2010, were considered for analysis. A total of thirty-eight peer-reviewed articles published since 2010 examining the quality and/or readability of online orthopaedic information were reviewed. For information quality, there was marked variation in the quality assessment methods utilized, the number of reviewers, and the manner of reporting. To date, the majority of examined information is of poor quality. Studies examining readability have focused on pages produced by professional orthopaedic societies. The quality and readability of online orthopaedic information are generally poor. For modern practices to adapt to the Internet and to prevent misinformation, the orthopaedic community should develop high-quality, readable online patient information. Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated.

Advanced practice physiotherapy in paediatric orthopaedics: innovation and collaboration to improve service delivery.

Science.gov (United States)

Ó Mír, M; O'Sullivan, C

2018-02-01

One in eight paediatric primary care presentations is for a musculoskeletal (MSK) disorder. These patients are frequently referred to paediatric orthopaedic surgeons; however, up to 50% of referrals are for normal variants. This results in excessive wait-times and impedes access for urgent surgical cases. Adult MSK medicine has successfully utilised advanced practice physiotherapists (APP) managing non-surgical candidates, with documented benefits both to patients and services. There is a gap in the literature with regard to APP in paediatric orthopaedics. In this review, we investigate demands on paediatric orthopaedic services, examine the literature regarding APP in paediatric orthopaedics and explore the value the role has to offer current outpatient services. Paediatric orthopaedic services are under-resourced with concurrent long wait times. Approximately 50% of referrals are for normal variants, which do not require specialist intervention. Poor musculoskeletal examination skills and low diagnostic confidence amongst primary care physicians have been identified as a cause of inappropriate referrals. APP clinics for normal variants have reported independent management rate and discharge rates of 95% and marked reduction in patient wait times. There is limited evidence to support the APP in paediatric orthopaedics. Further studies are needed investigating diagnostic agreement, patient/stakeholder satisfaction, patient outcomes and economic evaluation. Paediatric orthopaedics is in crisis as to how to effectively manage the overwhelming volume of referrals. Innovative multidisciplinary solutions are required so that the onus is not solely on physicians to provide all services. The APP in paediatric orthopaedics may be part of the solution.

Eos a Universal Verifiable and Coercion Resistant Voting Protocol

DEFF Research Database (Denmark)

Patachi, Stefan; Schürmann, Carsten

2017-01-01

Authority. Eos uses two mixing phases with the goal to break the connection between the voter and vote, not to preserve vote privacy (which is given already) but to guarantee coercion resistance by making it (nearly) impossible for a coercer to follow their vote through the bulletin board. Eos...

Eos and the Youth: A Case of Inverted Roles in Rape

Science.gov (United States)

Dipla, Anthi

This article examines scenes of Eos pursuing/abducting youths on 5th-century Athenian vases. Eos, the personification of Dawn, is the only woman assuming the role of a pursuer in rape. The theme strangely becomes very popular with vase painters to a degree comparable to ephebes pursuing a woman. The iconography of the scenes is systematically analysed and evaluated. All theories explaining the popularity of the theme from its presumable use as a parable for death are considered. Eos is moreover compared to other winged figures in pursuit that are popular in the same period, especially Sphinx and Eros. Conversely, it is illustrated how Eos' pursuits of youths are thoroughly coined on the same model as ephebe rape scenes. These may have been so popular because they expressed prevalent social notions about how women, like animals,would need subduing/taming by the ephebe, future citizen hunters, before they could assume their appropriate place in society. With Eos the hunter becomes the prey of a wild woman, who has transgressed the control limits set by the social system. Eos is promoted as the ultimate model of what a woman should not be.

Teleconsultation in paediatric orthopaedics in Djibouti: evaluation of response performance.

Science.gov (United States)

Bertani, A; Launay, F; Candoni, P; Mathieu, L; Rongieras, F; Chauvin, F

2012-11-01

Djibouti has no paediatric orthopaedics department and three options are available for difficult cases: transfer of the patient to another country; overseas mission transfer to Djibouti by a specialised surgical team; and management by a local orthopaedic surgeon receiving guidance from an expert. The extreme poverty of part of the population of Djibouti often precludes the first two options. Telemedecine can allow the local orthopaedic surgeon to receive expert advice. HYPOTHESES AND STUDY DESIGN: We prospectively recorded all the paediatric orthopaedics teleconsultations that occurred between November 2009 and November 2011. Our objective was to assess the performance of the teleconsultations. We hypothetized that this option was influential in decision making. We assessed the influence of the teleconsultation on patient management (i.e., change in the surgical indication and/or procedure). We then used the electronic patient records to compare the actual management to that recommended retrospectively by two independent orthopaedic surgeon consultants who had experience working overseas. Finally, we assessed the clinical outcomes in the patients. Of 48 teleconsultations for 39 patients, 13 dealt with diagnostic problems and 35 with therapeutic problems. The teleconsultation resolved the diagnostic uncertainties in 90% of cases. Advice from the expert modified the management in 37 (77%) teleconsultations; the change was related to the surgical indication in 18 cases, the surgical technique in 13 cases, and both in six cases. Agreement between the advice from the independent consultants and the treatment delivered by the local surgeon was 2.2/3. Clinical outcomes were good or very good in 31 (81%) of the 38 treated patients. This study establishes the feasibility and usefulness of paediatric orthopaedics teleconsultations in Djibouti. The introduction of telemedicine has changed our approach to challenges raised by patients in remote locations or precarious

Skeletal scintigraphy and SPECT/CT in orthopedic imaging

International Nuclear Information System (INIS)

Klaeser, B.; Walter, M.; Krause, T.

2011-01-01

Multi-modality imaging with SPECT-CT in orthopaedics combines the excellent sensitivity of scintigraphy with the morphological information of CT as a key for specific interpretation of findings in bone scans. The result is an imaging modality with the clear potential to prove of value even in a competitive setting dominated by MRI, and to significantly add to diagnostic imaging in orthopaedics. SPECT-CT is of great value in the diagnostic evaluation after fractures, and - in contrast to MRI - it is well suited for imaging in patients with osteosyntheses and metallic implants. In sports medicine, SPECT-CT allows for a sensitive and specific detection of osseous stress reactions before morphological changes become detectable by CT or MRI. In patients with osseous pain syndromes, actively evolving degenerative changes as a cause of pain can be identified and accurately localized. Further, particularly prospective diagnostic studies providing comparative data are needed to strengthen the position of nuclear imaging in orthopaedics and sports medicine and to help implementing SPECT/CT in diagnostic algorithms. (orig.)

3D-modeling of the spine using EOS imaging system: Inter-reader reproducibility and reliability.

Directory of Open Access Journals (Sweden)

Johannes Rehm

Full Text Available To retrospectively assess the interreader reproducibility and reliability of EOS 3D full spine reconstructions in patients with adolescent idiopathic scoliosis (AIS.73 patients with mean age of 17 years and a moderate AIS (median Cobb Angle 18.2° obtained low-dose standing biplanar radiographs with EOS. Two independent readers performed "full spine" 3D reconstructions of the spine with the "full-spine" method adjusting the bone contour of every thoracic and lumbar vertebra (Th1-L5. Interreader reproducibility was assessed regarding rotation of every single vertebra in the coronal (i.e. frontal, sagittal (i.e. lateral, and axial plane, T1/T12 kyphosis, T4/T12 kyphosis, L1/L5 lordosis, L1/S1 lordosis and pelvic parameters. Radiation exposure, scan-time and 3D reconstruction time were recorded.Interclass correlation (ICC ranged between 0.83 and 0.98 for frontal vertebral rotation, between 0.94 and 0.99 for lateral vertebral rotation and between 0.51 and 0.88 for axial vertebral rotation. ICC was 0.92 for T1/T12 kyphosis, 0.95 for T4/T12 kyphosis, 0.90 for L1/L5 lordosis, 0.85 for L1/S1 lordosis, 0.97 for pelvic incidence, 0.96 for sacral slope, 0.98 for sagittal pelvic tilt and 0.94 for lateral pelvic tilt. The mean time for reconstruction was 14.9 minutes (reader 1: 14.6 minutes, reader 2: 15.2 minutes, p<0.0001. The mean total absorbed dose was 593.4μGy ±212.3 per patient.EOS "full spine" 3D angle measurement of vertebral rotation proved to be reliable and was performed in an acceptable reconstruction time. Interreader reproducibility of axial rotation was limited to some degree in the upper and middle thoracic spine due the obtuse angulation of the pedicles and the processi spinosi in the frontal view somewhat complicating their delineation.

MIRANDA: The EO-sensor Performance Tool Powered by EOSTAR-PRO - poster (Abstract)

NARCIS (Netherlands)

Hammel, S.H.; Tsintikidis, D.; Adonidis, M.; Degache, M.A.C.; Lange, D.J.J. de; Eijk, A.M.J. van

2007-01-01

Over the last decades, considerable efforts have been made to assess the impact of theenvironment on EM and EO propagation. While encouraging progress has been made in the EM domain, few, if any, operational tools are available for the EO domain. As a consequence, no EO operational software,

42 Editorial ADVOCACY IN ORTHOPAEDICS

African Journals Online (AJOL)

2017-09-11

Sep 11, 2017 ... East African Orthopaedic Journal. Advocacy may be ... taxation of medical equipment and implants in Kenya. In 2013 a change ... Asia countries especially India were doing the opposite. They reduced ... Most developing countries have been dealing with communicable ... The role of advocacy is huge here.

Do Orthopaedic Surgeons Acknowledge Uncertainty?

NARCIS (Netherlands)

Teunis, Teun; Janssen, Stein; Guitton, Thierry G.; Ring, David; Parisien, Robert

2016-01-01

Much of the decision-making in orthopaedics rests on uncertain evidence. Uncertainty is therefore part of our normal daily practice, and yet physician uncertainty regarding treatment could diminish patients' health. It is not known if physician uncertainty is a function of the evidence alone or if

Reading the small print - labelling recommendations for orthopaedic implants.

Science.gov (United States)

Haene, Roger A; Sandhu, Ranbir S; Baxandall, Richard

2009-11-01

There exist, currently, no clear guidelines regarding standards for surgical implant labelling. Dimensions of the laminar flow canopies in orthopaedic use fixes the distance at which implant labels can be read. Mistakes when reading the label on an implant box can pose health risks for patients, and financial consequences for medical institutions. Using scientifically validated tools such as the Snellen Chart Formula, a theoretical minimum standard for text on implant labels was reached. This theoretical standard was then tested under real operating conditions. After discovering a minimum practical standard for implant labels, the authors then audited current labels in use on a wide range of orthopaedic implant packages. Furthermore, other non-text-related labelling problems were also noted. There is a definite minimum standard which should be observed when implant labels are manufactured. Implants in current use bear labels on the packaging that are of an insufficient standard to ensure patient safety in theatre. The authors have established text parameters that will increase the legibility of implant labels. In the interests of improving risk management in theatre, therefore, the authors propose a standard for orthopaedic implant labelling, and believe this will provide a useful foundation for further discussion between the orthopaedic community and implant manufacturers.

American Orthopaedic Society for Sports Medicine

Science.gov (United States)

... Upcoming Meetings Online Education Archived Meetings Faculty Resources Sports Medicine Fellowships Traveling Fellowship Submit an Abstract Submit ... Support AOSSM Research Publications Toggle American Journal of Sports Medicine Sports Health: A Multidisciplinary Approach Orthopaedic Journal ...

77 FR 3211 - USACE's Plan for Retrospective Review Under E.O. 13563

Science.gov (United States)

2012-01-23

... for Retrospective Review Under E.O. 13563 AGENCY: U.S. Army Corps of Engineers, DoD. ACTION: Extension..., ``Improving Regulation and Regulatory Review'' (E.O.), issued on January 18, 2011, directs federal agencies to... Regulatory mission; thus, USACE believes they are a significant rule warranting review pursuant to E.O. 13563...

An Observation Capability Metadata Model for EO Sensor Discovery in Sensor Web Enablement Environments

Directory of Open Access Journals (Sweden)

Chuli Hu

2014-10-01

Full Text Available Accurate and fine-grained discovery by diverse Earth observation (EO sensors ensures a comprehensive response to collaborative observation-required emergency tasks. This discovery remains a challenge in an EO sensor web environment. In this study, we propose an EO sensor observation capability metadata model that reuses and extends the existing sensor observation-related metadata standards to enable the accurate and fine-grained discovery of EO sensors. The proposed model is composed of five sub-modules, namely, ObservationBreadth, ObservationDepth, ObservationFrequency, ObservationQuality and ObservationData. The model is applied to different types of EO sensors and is formalized by the Open Geospatial Consortium Sensor Model Language 1.0. The GeosensorQuery prototype retrieves the qualified EO sensors based on the provided geo-event. An actual application to flood emergency observation in the Yangtze River Basin in China is conducted, and the results indicate that sensor inquiry can accurately achieve fine-grained discovery of qualified EO sensors and obtain enriched observation capability information. In summary, the proposed model enables an efficient encoding system that ensures minimum unification to represent the observation capabilities of EO sensors. The model functions as a foundation for the efficient discovery of EO sensors. In addition, the definition and development of this proposed EO sensor observation capability metadata model is a helpful step in extending the Sensor Model Language (SensorML 2.0 Profile for the description of the observation capabilities of EO sensors.

Investigation on Alteration of Compression of Knitted Orthopaedic Supports during Exploitation

Directory of Open Access Journals (Sweden)

Diana ALIŠAUSKIENĖ

2012-12-01

Full Text Available One of the areas of medical textile is the spacer knitted orthopaedic products. The concept of compression therapy of orthopaedic supports lies on a simple and efficient mechanical principle – it consists of applying elastic garment around the limb. Spacer orthopaedic supports are knitted on flat knitting machines equipped with especial elastomeric thread feeder. Compression made by the support depends on the support area, shape and characteristics of knitting. Because of orthopaedic supports are intended for durable wearing and need to vouchsafe compression of fixed value, it is very important to known how processes acting during exploitation influence alteration of compression values. The aim of this study was to establish the alteration of compression of knitted support during exploitation, i. e. after multifold extension, washing and drying. The samples were knitted on a flat double needle bed knitting machine in combined jacquard-laid-in pattern with elastomeric weft threads. It was established that compressive properties of knits after cyclic tensile load changed slightly, i. e. range between margins of error. It was measured that knitted orthopaedic supports dimensions and density after washing and drying cycles changes significant, i. e. knitted supports shrinks and thickens and their compression decreases.DOI: http://dx.doi.org/10.5755/j01.ms.18.4.3097

Do Orthopaedic Surgeons Acknowledge Uncertainty?

Science.gov (United States)

Teunis, Teun; Janssen, Stein; Guitton, Thierry G; Ring, David; Parisien, Robert

2016-06-01

Much of the decision-making in orthopaedics rests on uncertain evidence. Uncertainty is therefore part of our normal daily practice, and yet physician uncertainty regarding treatment could diminish patients' health. It is not known if physician uncertainty is a function of the evidence alone or if other factors are involved. With added experience, uncertainty could be expected to diminish, but perhaps more influential are things like physician confidence, belief in the veracity of what is published, and even one's religious beliefs. In addition, it is plausible that the kind of practice a physician works in can affect the experience of uncertainty. Practicing physicians may not be immediately aware of these effects on how uncertainty is experienced in their clinical decision-making. We asked: (1) Does uncertainty and overconfidence bias decrease with years of practice? (2) What sociodemographic factors are independently associated with less recognition of uncertainty, in particular belief in God or other deity or deities, and how is atheism associated with recognition of uncertainty? (3) Do confidence bias (confidence that one's skill is greater than it actually is), degree of trust in the orthopaedic evidence, and degree of statistical sophistication correlate independently with recognition of uncertainty? We created a survey to establish an overall recognition of uncertainty score (four questions), trust in the orthopaedic evidence base (four questions), confidence bias (three questions), and statistical understanding (six questions). Seven hundred six members of the Science of Variation Group, a collaboration that aims to study variation in the definition and treatment of human illness, were approached to complete our survey. This group represents mainly orthopaedic surgeons specializing in trauma or hand and wrist surgery, practicing in Europe and North America, of whom the majority is involved in teaching. Approximately half of the group has more than 10 years

A basic introduction to statistics for the orthopaedic surgeon.

Science.gov (United States)

Bertrand, Catherine; Van Riet, Roger; Verstreken, Frederik; Michielsen, Jef

2012-02-01

Orthopaedic surgeons should review the orthopaedic literature in order to keep pace with the latest insights and practices. A good understanding of basic statistical principles is of crucial importance to the ability to read articles critically, to interpret results and to arrive at correct conclusions. This paper explains some of the key concepts in statistics, including hypothesis testing, Type I and Type II errors, testing of normality, sample size and p values.

Assessing the Agreement Between Eo-Based Semi-Automated Landslide Maps with Fuzzy Manual Landslide Delineation

Science.gov (United States)

Albrecht, F.; Hölbling, D.; Friedl, B.

2017-09-01

Landslide mapping benefits from the ever increasing availability of Earth Observation (EO) data resulting from programmes like the Copernicus Sentinel missions and improved infrastructure for data access. However, there arises the need for improved automated landslide information extraction processes from EO data while the dominant method is still manual delineation. Object-based image analysis (OBIA) provides the means for the fast and efficient extraction of landslide information. To prove its quality, automated results are often compared to manually delineated landslide maps. Although there is awareness of the uncertainties inherent in manual delineations, there is a lack of understanding how they affect the levels of agreement in a direct comparison of OBIA-derived landslide maps and manually derived landslide maps. In order to provide an improved reference, we present a fuzzy approach for the manual delineation of landslides on optical satellite images, thereby making the inherent uncertainties of the delineation explicit. The fuzzy manual delineation and the OBIA classification are compared by accuracy metrics accepted in the remote sensing community. We have tested this approach for high resolution (HR) satellite images of three large landslides in Austria and Italy. We were able to show that the deviation of the OBIA result from the manual delineation can mainly be attributed to the uncertainty inherent in the manual delineation process, a relevant issue for the design of validation processes for OBIA-derived landslide maps.

Clinical validation of the avidin/indium-111 biotin approach for imaging infection/inflammation in orthopaedic patients

International Nuclear Information System (INIS)

Lazzeri, E.; Molea, N.; Bodei, L.; Bianchi, R.; Manca, M.; Marchetti, S.; Consoli, V.; Chinol, M.; Paganelli, G.; Mariani, G.

1999-01-01

We report here the results of a validation study of the avidin/indium-111 biotin approach in patients with skeletal lesions. This study involved 54 patients with orthopaedic conditions: 20 patients with intermediate suspected osteomyelitis of the trunk, 19 patients with infection/inflammation of prosthetic joint replacements, and 15 patients with suspected osteomyelitis of appendicular bones. Avidin (3 mg) was injected as an i.v. bolus, followed 4 h later by 111 In-biotin; imaging was acquired 30 min and 16-18 h after administration of 111 In-biotin. Technetium-99m hexamethylpropylene amine oxime ( 99m Tc-HMPAO)-labelled leucocyte scintigraphy was performed in 39/54 patients. The overall sensitivity of the avidin/ 111 In-biotin scan was 97.7% (versus 88.9% for 99m Tc-HMPAO leucocyte scintigraphy). While the diagnostic performance of avidin/ 111 In-biotin scintigraphy was similar to that of 99m Tc-HMPAO leucocyte scintigraphy in patients with prosthetic joint replacements or osteomyelitis of appendicular bones, the avidin/ 111 In-biotin approach clearly performed better than 99m Tc-HMPAO leucocyte scintigraphy in patients with suspected osteomyelitis of the trunk (100% sensitivity, specificity and accuracy versus 50% sensitivity, 100% specificity and 66.7% accuracy for 99m Tc-HMPAO-leucocyte scintigraphy). These results demonstrate the feasibility of the avidin/ 111 In-biotin approach for imaging sites of infection/inflammation in the clinical setting. Although no systematic advantages of avidin/ 111 In-biotin scintigraphy were found versus 99m Tc-HMPAO leucocyte scintigraphy, the newer scintigraphic method is more practicable and involves lower biological risk for the operators. (orig.)

Recent disruption of an asteroid from the Eos family

Science.gov (United States)

Novaković, B.; Tsirvoulis, G.

2014-07-01

A key difficulty with searching for partially differentiated asteroids arises from the fact that a crust covers the exterior of the body, and, consequently, should hide the melted interior. This motivates an alternative approach of examining members of asteroid families, i.e., fragments of single large bodies, many of which were in the size regime capable of igneous differentiation, that have been disrupted by catastrophic collisions. Such families could provide a stratigraphic cross section across the interior of the parent asteroid [1]. With more than 10,000 known members, the Eos dynamical family is one of the most numerous and earliest recognized asteroid families [2]. Interestingly, the estimated ˜220-km-diameter parent body [3] is well within the size range capable of differentiation. Thus, existing family members should contain fragments of the deep interior. The Eos family has the highest diversity of taxonomic classes than any other known family [4]. Many members are of K spectral type, which is uncommon outside the family, and is similar to the spectra of CV, CK, CO, and CR carbonaceous chondrites [5]. This diversity leads to the suggestion that the Eos parent body was partially differentiated [4,6]. Thus, the Eos family may not only be a remnant of a partially differentiated parent body, but it could be the source of the CV-CK meteorite group. Here we report the discovery of a young subfamily of the Eos asteroid family. It may help understanding the mineralogical nature of the Eos asteroid family and of its parent body. By applying the hierarchical clustering method [7], we find an extremely compact 16-body cluster within the borders of the Eos family. We name the cluster (6733) 1992 EF, after its largest member. The statistical significance of this new cluster is estimated to be above 99%, indicating that its members share a common origin. All members of the cluster are found to be dynamically stable over long timescales. Backward numerical orbital

77 FR 66848 - Minimum Clinically Important Difference: An Outcome Metric in Orthopaedic Device Science and...

Science.gov (United States)

2012-11-07

...] Minimum Clinically Important Difference: An Outcome Metric in Orthopaedic Device Science and Regulation... Clinically Important Difference: An Outcome Metric in Orthopaedic Device Science and Regulation.'' FDA is co... (MCID) for patient-reported outcome (PRO) instruments used in orthopaedic extremity device-related...

Access to Orthopaedic Surgical Care in Northern Tanzania: A Modelling Study.

Science.gov (United States)

Premkumar, Ajay; Ying, Xiaohan; Mack Hardaker, W; Massawe, Honest H; Mshahaba, David J; Mandari, Faiton; Pallangyo, Anthony; Temu, Rogers; Masenga, Gileard; Spiegel, David A; Sheth, Neil P

2018-04-25

The global burden of musculoskeletal disease and resulting disability is enormous and is expected to increase over the next few decades. In the world's poorest regions, the paucity of information defining and quantifying the current state of access to orthopaedic surgical care is a major problem in developing effective solutions. This study estimates the number of individuals in Northern Tanzania without adequate access to orthopaedic surgical services. A chance tree was created to model the probability of access to orthopaedic surgical services in the Northern Tanzanian regions of Arusha, Kilimanjaro, Tanga, Singida, and Manyara, with respect to four dimensions: timeliness, surgical capacity, safety, and affordability. Timeliness was estimated by the proportion of people living within a 4-h driving distance from a hospital with an orthopaedic surgeon, capacity by comparing number of surgeries performed to the number of surgeries indicated, safety by applying WHO Emergency and Essential Surgical Care infrastructure and equipment checklists, and affordability by approximating the proportion of the population protected from catastrophic out-of-pocket healthcare expenditure. We accounted for uncertainty in our model with one-way and probabilistic sensitivity analyses. Data sources included the Tanzanian National Bureau of Statistics and Ministry of Finance, World Bank, World Health Organization, New Zealand Ministry of Health, Google Corporation, NASA population estimator, and 2015 hospital records from Kilimanjaro Christian Medical Center, Machame Hospital, Nkoroanga Hospital, Mt. Meru Hospital, and Arusha Lutheran Medical Center. Under the most conservative assumptions, more than 90% of the Northern Tanzanian population does not have access to orthopaedic surgical services. There is a near absence of access to orthopaedic surgical care in Northern Tanzania. These findings utilize more precise country and region-specific data and are consistent with prior published

Eosinophilic Esophagitis in Children and Adolescents with Abdominal Pain: Comparison with EoE-Dysphagia and Functional Abdominal Pain.

Science.gov (United States)

Gunasekaran, Thirumazhisai; Prabhakar, Gautham; Schwartz, Alan; Gorla, Kiranmai; Gupta, Sandeep; Berman, James

2016-01-01

Aim. Compare EoE-AP with EoE-D for clinical, endoscopy (EGD), histology and outcomes and also with FAP-N. Method. Symptoms, physical findings, EGD, histology, symptom scores, and treatments were recorded for the three groups. Cluster analysis was done. Results. Dysphagia and abdominal pain were different in numbers but not statistically significant between EoE-AP and EoE-D. EGD, linear furrows, white exudates were more in the EoE-D and both combined were significant (p < 0.05). EoE-D, peak and mean eosinophils (p  0.06) and eosinophilic micro abscesses (p  0.001) were higher. Follow-Up. Based on single symptom, EoE-AP had 30% (p  0.25) improvement, EoE-D 86% (p < 0.001) and similar with composite score (p  0.57 and <0.001, resp.). Patients who had follow-up, EGD: 42.8% with EoE-AP and 77.8% with EoE-D, showed single symptom improvement and the eosinophil count fell from 38.5/34.6 (peak and mean) to 31.2/30.4 (p  0.70) and from 43.6/40.8 to 25.2/22.8 (p < 0.001), respectively. FAP-N patients had similar symptom improvement like EoE-D. Cluster Analysis. EoE-AP and FAP-N were similar in clinical features and response to treatment, but EoE-D was distinctly different from EoE-AP and FAP-N. Conclusion. Our study demonstrates that EoE-AP and EoE-D have different histology and outcomes. In addition, EoE-AP has clinical features similar to the FAP-N group.

Corruption in the health care sector: A barrier to access of orthopaedic care and medical devices in Uganda.

Science.gov (United States)

Bouchard, Maryse; Kohler, Jillian C; Orbinski, James; Howard, Andrew

2012-05-03

Globally, injuries cause approximately as many deaths per year as HIV/AIDS, tuberculosis and malaria combined, and 90% of injury deaths occur in low- and middle- income countries. Given not all injuries kill, the disability burden, particularly from orthopaedic injuries, is much higher but is poorly measured at present. The orthopaedic services and orthopaedic medical devices needed to manage the injury burden are frequently unavailable in these countries. Corruption is known to be a major barrier to access of health care, but its effects on access to orthopaedic services is still unknown. A qualitative case study of 45 open-ended interviews was conducted to investigate the access to orthopaedic health services and orthopaedic medical devices in Uganda. Participants included orthopaedic surgeons, related healthcare professionals, industry and government representatives, and patients. Participants' experiences in accessing orthopaedic medical devices were explored. Thematic analysis was used to analyze and code the transcripts. Analysis of the interview data identified poor leadership in government and corruption as major barriers to access of orthopaedic care and orthopaedic medical devices. Corruption was perceived to occur at the worker, hospital and government levels in the forms of misappropriation of funds, theft of equipment, resale of drugs and medical devices, fraud and absenteeism. Other barriers elicited included insufficient health infrastructure and human resources, and high costs of orthopaedic equipment and poverty. This study identified perceived corruption as a significant barrier to access of orthopaedic care and orthopaedic medical devices in Uganda. As the burden of injury continues to grow, the need to combat corruption and ensure access to orthopaedic services is imperative. Anti-corruption strategies such as transparency and accountability measures, codes of conduct, whistleblower protection, and higher wages and benefits for workers could be

Corruption in the health care sector: A barrier to access of orthopaedic care and medical devices in Uganda

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Bouchard Maryse

2012-05-01

Full Text Available Abstract Background Globally, injuries cause approximately as many deaths per year as HIV/AIDS, tuberculosis and malaria combined, and 90% of injury deaths occur in low- and middle- income countries. Given not all injuries kill, the disability burden, particularly from orthopaedic injuries, is much higher but is poorly measured at present. The orthopaedic services and orthopaedic medical devices needed to manage the injury burden are frequently unavailable in these countries. Corruption is known to be a major barrier to access of health care, but its effects on access to orthopaedic services is still unknown. Methods A qualitative case study of 45 open-ended interviews was conducted to investigate the access to orthopaedic health services and orthopaedic medical devices in Uganda. Participants included orthopaedic surgeons, related healthcare professionals, industry and government representatives, and patients. Participants’ experiences in accessing orthopaedic medical devices were explored. Thematic analysis was used to analyze and code the transcripts. Results Analysis of the interview data identified poor leadership in government and corruption as major barriers to access of orthopaedic care and orthopaedic medical devices. Corruption was perceived to occur at the worker, hospital and government levels in the forms of misappropriation of funds, theft of equipment, resale of drugs and medical devices, fraud and absenteeism. Other barriers elicited included insufficient health infrastructure and human resources, and high costs of orthopaedic equipment and poverty. Conclusions This study identified perceived corruption as a significant barrier to access of orthopaedic care and orthopaedic medical devices in Uganda. As the burden of injury continues to grow, the need to combat corruption and ensure access to orthopaedic services is imperative. Anti-corruption strategies such as transparency and accountability measures, codes of conduct

Corruption in the health care sector: A barrier to access of orthopaedic care and medical devices in Uganda

Science.gov (United States)

2012-01-01

Background Globally, injuries cause approximately as many deaths per year as HIV/AIDS, tuberculosis and malaria combined, and 90% of injury deaths occur in low- and middle- income countries. Given not all injuries kill, the disability burden, particularly from orthopaedic injuries, is much higher but is poorly measured at present. The orthopaedic services and orthopaedic medical devices needed to manage the injury burden are frequently unavailable in these countries. Corruption is known to be a major barrier to access of health care, but its effects on access to orthopaedic services is still unknown. Methods A qualitative case study of 45 open-ended interviews was conducted to investigate the access to orthopaedic health services and orthopaedic medical devices in Uganda. Participants included orthopaedic surgeons, related healthcare professionals, industry and government representatives, and patients. Participants’ experiences in accessing orthopaedic medical devices were explored. Thematic analysis was used to analyze and code the transcripts. Results Analysis of the interview data identified poor leadership in government and corruption as major barriers to access of orthopaedic care and orthopaedic medical devices. Corruption was perceived to occur at the worker, hospital and government levels in the forms of misappropriation of funds, theft of equipment, resale of drugs and medical devices, fraud and absenteeism. Other barriers elicited included insufficient health infrastructure and human resources, and high costs of orthopaedic equipment and poverty. Conclusions This study identified perceived corruption as a significant barrier to access of orthopaedic care and orthopaedic medical devices in Uganda. As the burden of injury continues to grow, the need to combat corruption and ensure access to orthopaedic services is imperative. Anti-corruption strategies such as transparency and accountability measures, codes of conduct, whistleblower protection, and higher

Management of Spinal Tuberculosis - A Metropolitan City Based Survey Among Orthopaedic and Neurosurgeons

International Nuclear Information System (INIS)

Muhammad, T.

2015-01-01

Objective: To explore the core understanding of spinal tuberculosis and its current management plans by orthopaedics and neurosurgeons. Methods: The questionnaire-based study was conducted from July 2011 to November 2012 in Karachi and comprised consultant orthopaedics and neurosurgeons belonging to 4 private and 3 government tertiary care teaching hospitals and having a minimum five years of post-fellowship experience. A pre-designed questionnaire was used to explore the current practice in spinal tuberculosis regarding its clinical presentation, diagnosis and treatment. SPSS 15 was used for statistical analysis. Results: There were 48 subjects in the study; 24(50 percent) orthopaedic surgeons and 24(50 percent) neurosurgeons. According to 44(91.70 percent) respondents, common age for spinal tuberculosis was second and third decades of life, and 37(77.08 percent)reported refractory back pain with or without neurological deficits as the commonest clinical finding. Typical magnetic resonance imaging findings was the uniform observation of all the 48(100 percent) respondents. Diagnosis was made by histopathological findings by 39(81.25 percent) respondents. Anti-tuberculosis therapy was started empirically on the basis of clinical, laboratory and radiological findings by 33(68.75 percent) respondents. Those in favour of giving anti-tuberculosis therapy for 18 months were 32(66.7 percent) respondents, and 33(68.75 percent) thought surgery does not expedite recovery. Conclusion: Extremely variable tools of diagnosis and diversified approaches for the treatment are alarming signs for the possible development of resistant strains and complications of spinal tuberculosis. (author)

"Is There An App For That?" Orthopaedic Patient Preferences For A Smartphone Application.

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Datillo, Jonathan R; Gittings, Daniel J; Sloan, Matthew; Hardaker, William M; Deasey, Matthew J; Sheth, Neil P

2017-08-16

Patients are seeking out medical information on the Internet and utilizing smartphone health applications ("apps"). Smartphone use has exponentially increased among orthopaedic surgeons and patients. Despite this increase, patients are rarely directed to specific apps by physicians. No study exists querying patient preferences for a patient-centered, orthopaedic smartphone application. The purpose of this study is to 1) determine Internet use patterns amongst orthopaedic patients; 2) ascertain access to and use of smartphones; and 3) elucidate what features orthopaedic patients find most important in a smartphone application. We surveyed patients in an orthopaedic practice in an urban academic center to assess demographics, access to and patterns of Internet and Smartphone use, and preferences for features in a smartphone app. A total of 310 surveys were completed. Eighty percent of patients reported Internet access, and 62% used the Internet for health information. Seventy-seven percent owned smartphones, 45% used them for health information, and 28% owned health apps. Only 11% were referred to an app by a physician. The highest ranked features were appointment reminders, ability to view test results, communication with physicians, and discharge instructions. General orthopaedic information and pictures or videos explaining surgery were the 2 lowest ranked features. Seventy-one percent of patients felt an app with some of the described features would improve their healthcare experiences, and 40% would pay for the app. The smartphone is an under-utilized tool to enhance patient-physician communication, increase satisfaction, and improve quality of care. Patients were enthusiastic about app features that are often included in patient health portals, but ranked orthopaedic educational features lowest. Further study is required to elucidate how best to use orthopaedic apps as physician-directed educational opportunities to promote patient satisfaction and quality of

Prevalence and factors of burnout among Australian orthopaedic trainees: a cross-sectional study.

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Arora, Manit; Diwan, Ashish D; Harris, Ian A

2014-12-01

To assess the prevalence and factors of burnout among Australian orthopaedic trainees. 236 orthopaedic registrars of the Australian Orthopaedic Association were invited to participate in a 32-item survey by email. The questionnaire assessed potential factors associated with burnout, satisfaction with the choice of orthopaedics as a career and work-life balance, and subjective overall health, as well as 3 subscales of the Maslach Burnout Inventory - Human Services Survey for assessing burnout: emotional exhaustion, depersonalisation, and personal accomplishment. Participants with high levels of either emotional exhaustion or depersonalisation were defined as having burnout. Those with and without burnout were compared. 51 (22%) of the 236 trainees completed the questionnaire. Of whom, 88% were satisfied with their choice of orthopaedics as a career, whereas 27% were satisfied with their work-life balance. 27 (53%) respondents were considered burned out. Compared with those who did not burn out, those who burned out were less satisfied with their careers (p=0.004) and work-life balance (p=0.021). 53% of Australian orthopaedic trainees were burned out. Burnout trainees were more likely to be dissatisfied with their career choice and worklife balance. Active interventions to combat burnout and improve work-life balance are needed.

Pediatric Orthopaedic Workforce in 2014: Current Workforce and Projections for the Future.

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Sawyer, Jeffrey R; Jones, Kerwyn C; Copley, Lawson A; Chambers, Stephanie

2017-01-01

The changing nature of the United States (US) health care system has prompted debate concerning the physician supply. The basic questions are: do we have an adequate number of surgeons to meet current demands and are we training the correct number of surgeons to meet future demands? The purpose of this analysis was to characterize the current pediatric orthopaedic workforce in terms of supply and demand, both present and future. Databases were searched (POSNA, SF Match, KID, MGMA) to determine the current pediatric orthopaedic workforce and workforce distribution, as well as pediatric orthopaedic demand. The number of active Pediatric Orthopaedic Society of North America (POSNA) members increased over the past 20 years, from 410 in 1993 to 653 in 2014 (155% increase); however, the density of POSNA members is not equally distributed, but correlates to population density. The number of estimated pediatric discharges, orthopaedic and nonorthopaedic, has remained relatively stable from 6,348,537 in 1997 to 5,850,184 in 2012. Between 2003 and 2013, the number of pediatric orthopaedic fellows graduating from Accreditation Council for Graduate Medical Education and non-Accreditation Council for Graduate Medical Education programs increased from 39 to 50 (29%), with a peak of 67 fellows (71%) in 2009. Although predicting the exact need for pediatric orthopaedic surgeons (POS) is impossible because of the complex interplay among macroeconomic, governmental, insurance, and local factors, some trends were identified: the supply of POS has increased, which may offset the expected numbers of experienced surgeons who will be leaving the workforce in the next 10 to 15 years; macroeconomic factors influencing demand for physician services, driven by gross domestic product and population growth, are expected to be stable in the near future; expansion of the scope of practice for POS is expected to continue; and further similar assessments are warranted. Level II-economic and

Etiology of Readmissions Following Orthopaedic Procedures and Medical Admissions. A Comparative Analysis.

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Maslow, Jed; Hutzler, Lorraine; Slover, James; Bosco, Joseph

2015-12-01

The Federal Government, the largest payer of health care, considers readmission within 30 days of discharge an indicator of quality of care. Many studies have focused on causes for and strategies to reduce readmissions following medical admissions. However, few studies have focused on the differences between them. We believe that the causes for readmission following orthopaedic surgery are markedly different than those following medical admissions, and therefore, the strategies developed to reduce medical readmissions will not be as effective in reducing readmissions after elective orthopaedic surgery. All unplanned 30-day readmissions following an index hospitalization for an elective orthopaedic procedure (primary and revision total joint arthroplasty and spine procedure) or for one of the three publicly reported medical conditions (AMI, HF, and pneumonia, which accounted for 11% of readmissions) were identified at our institution from 2010 through 2012. A total of 268 patients and 390 medical patients were identified as having an unplanned 30-day readmission. We reviewed a prospectively collected data base to determine the reason for readmission in each encounter. A total of 233 (86.9%) orthopaedic patients were readmitted for surgical complications, most commonly for a wound infection (56.0%) or wound complication (11.6%). Following an index admission of HF or AMI, the primary reason for readmission was a disease of the circulatory system (55.9% and 57.4%, respectively). Following an index admission for pneumonia, the primary reason for readmission was a disease of the respiratory system (34.5%). The causes of readmissions following orthopaedic surgery and medical admissions are different. Patients undergoing orthopaedic procedures are readmitted for surgical complications, frequently unrelated to aftercare, and medicine patients are readmitted for reasons related to the index diagnosis. Interventions designed to reduce orthopaedic readmissions must focus on

Readability of Orthopaedic Oncology-related Patient Education Materials Available on the Internet.

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Shah, Akash K; Yi, Paul H; Stein, Andrew

2015-12-01

A person's health literacy is one of the most important indicators of a patient's health status. According to national recommendations, patient education materials should be written at no higher than the sixth- to eighth-grade reading level. The purpose of our study was to assess the readability of online patient education materials related to orthopaedic oncology on the websites of the American Academy of Orthopaedic Surgeons (AAOS), American Cancer Society (ACS), Bone and Cancer Foundation (BCF), and National Cancer Institute (NCI). We searched the online patient education libraries of the AAOS, ACS, BCF, and NCI for all articles related to orthopaedic oncology. The Flesch-Kincaid (FK) readability score was calculated for each article and compared between sources. A total of 227 articles were identified with an overall mean FK grade level of 9.8. Stratified by source, the mean FK grade levels were 10.1, 9.6, 11.1, and 9.5 for the AAOS, ACS, BCF, and NCI, respectively (P education materials related to orthopaedic oncology appear to be written at a level above the comprehension ability of the average patient. Copyright 2015 by the American Academy of Orthopaedic Surgeons.

Long Sick Leave after Orthopaedic Inpatient Rehabilitation: Treatment Failure or Relapse?

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Mangels, Marija; Schwarz, Susanne; Worringen, Ulrike; Holme, Martin; Rief, Winfried

2011-01-01

We investigated whether short-term versus long-term sick leave after orthopaedic inpatient rehabilitation can be predicted by initial assessment information, the clinical status at discharge, or whether the follow-up interval is crucial for later sick leave. We examined 214 patients from an orthopaedic rehabilitation hospital at admission,…

International Patients on Operation Vacation – Perspectives of Patients Travelling to Hungary for Orthopaedic Treatments

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Eszter Kovacs

2014-11-01

Full Text Available Background The importance of cross-border healthcare, medical and health tourism plays a significant role in the European health policy and health management. After dentistry, orthopaedic treatments are the leading motivation for seeking care in Hungary, as patients with rheumatic and motion diseases are drawn to the thermal spas and well-established orthopaedic centres. This paper aims to gain insight into foreign patients’ perspectives on their experience of having sought medical tourism in orthopaedic care in Hungary. Methods A patient survey was conducted in 2012 on motivations for seeking treatment abroad, orthopaedic care received and overall satisfaction. In addition, health professionals’ interviews, and 17 phone interviews were conducted in 2013 with Romanian patients who had orthopaedic treatment in Hungary. Finally, medical records of foreign patients were analysed. Results The survey was completed by 115 participants – 61.1% females, mean age= 41.9, 87% Romanian origin. Most of the patients came to Hungary for orthopaedic surgeries, e.g. arthroscopy, knee/hip prosthesis or spinal surgery. 72.6% chose Hungary because of related to perceived better quality and longstanding culture of Hungarian orthopaedic care. Over 57% of patients reported being ‘very satisfied’ with care received and 41.6% ‘satisfied’. The follow-up interviews further reflected this level of satisfaction, therefore many respondents stating they have already recommended the Hungarian healthcare to others. Conclusion Based on the findings, patients from neighbouring regions are increasingly seeking orthopaedic care in Hungary. Patients having orthopaedic care are highly satisfied with the quality of care, the whole treatment process from the availability of information to discharge summaries and would consider returning for further treatments.

Bioactive Coatings for Orthopaedic Implants—Recent Trends in Development of Implant Coatings

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Bill G. X. Zhang

2014-07-01

Full Text Available Joint replacement is a major orthopaedic procedure used to treat joint osteoarthritis. Aseptic loosening and infection are the two most significant causes of prosthetic implant failure. The ideal implant should be able to promote osteointegration, deter bacterial adhesion and minimize prosthetic infection. Recent developments in material science and cell biology have seen the development of new orthopaedic implant coatings to address these issues. Coatings consisting of bioceramics, extracellular matrix proteins, biological peptides or growth factors impart bioactivity and biocompatibility to the metallic surface of conventional orthopaedic prosthesis that promote bone ingrowth and differentiation of stem cells into osteoblasts leading to enhanced osteointegration of the implant. Furthermore, coatings such as silver, nitric oxide, antibiotics, antiseptics and antimicrobial peptides with anti-microbial properties have also been developed, which show promise in reducing bacterial adhesion and prosthetic infections. This review summarizes some of the recent developments in coatings for orthopaedic implants.

Report of the EOS oceans panel to the payload panel

Science.gov (United States)

Abbott, Mark R.; Freilich, Michael H.

1992-11-01

The atmosphere and the ocean are the two great fluids of the earth system. Changes in the coupling of these two fluids will have a profound impact on the Earth's climate and biogeochemical systems. Although changes in atmospheric composition and dynamics are the usual focus of global climate models, it is apparent that the ocean plays a critical role in modulating the magnitude and rate of these changes. The ocean is responsible for nearly half of the poleward heat flux as well as for a significant portion of the uptake of atmospheric carbon dioxide. However, the processes governing the flux of materials and energy between the ocean atmosphere are poorly understood. Such processes include not only physical and chemical dynamics, but also biological processes which act to modify the chemical composition of the ocean as well as the trapping of solar energy as heat in the upper water column. Thus it is essential that the ocean be studied as a complete system of physical, chemical, and biological processes. Overlapping measurements must be made for at least 10-15 years to resolve critical low frequency fluctuations. The present EOS plan relies heavily on non-EOS entities to provide critical data sets for ocean studies. Although such partnerships are usually beneficial, there are risks that must be considered in terms of data coverage, quality, resolution, and availability. A simple replacement of an EOS sensor with a non-EOS sensor based on the fact that they both measure the same quantities will not guarantee that critical measurements will be made to address IPCC priorities in the area of ocean processes. EOS must continue to pursue appropriate methods to ensure that such partner — provided measurements meet scientific requirements. Such methods are analogous to contigencies applied in the area of schedules, cost, and performance for instrument projects. EOS must foster strong ties between US scientists and their foreign counterparts, in order to develop

Clinical validation of the avidin/indium-111 biotin approach for imaging infection/inflammation in orthopaedic patients

Energy Technology Data Exchange (ETDEWEB)

Lazzeri, E.; Molea, N.; Bodei, L.; Bianchi, R. [Regional Centre of Nuclear Medicine, University of Pisa, Pisa (Italy); Manca, M.; Marchetti, S.; Consoli, V. [Institute of Orthopedics, University of Pisa, Pisa (Italy); Chinol, M.; Paganelli, G. [Nuclear Medicine Service, European Institute of Oncology, Milan (Italy); Mariani, G. [Nuclear Medicine Service, DIMI, University of Genoa, Genoa (Italy)

1999-06-01

We report here the results of a validation study of the avidin/indium-111 biotin approach in patients with skeletal lesions. This study involved 54 patients with orthopaedic conditions: 20 patients with intermediate suspected osteomyelitis of the trunk, 19 patients with infection/inflammation of prosthetic joint replacements, and 15 patients with suspected osteomyelitis of appendicular bones. Avidin (3 mg) was injected as an i.v. bolus, followed 4 h later by {sup 111}In-biotin; imaging was acquired 30 min and 16-18 h after administration of {sup 111}In-biotin. Technetium-99m hexamethylpropylene amine oxime ({sup 99m}Tc-HMPAO)-labelled leucocyte scintigraphy was performed in 39/54 patients. The overall sensitivity of the avidin/{sup 111}In-biotin scan was 97.7% (versus 88.9% for {sup 99m}Tc-HMPAO leucocyte scintigraphy). While the diagnostic performance of avidin/{sup 111}In-biotin scintigraphy was similar to that of {sup 99m}Tc-HMPAO leucocyte scintigraphy in patients with prosthetic joint replacements or osteomyelitis of appendicular bones, the avidin/{sup 111}In-biotin approach clearly performed better than {sup 99m}Tc-HMPAO leucocyte scintigraphy in patients with suspected osteomyelitis of the trunk (100% sensitivity, specificity and accuracy versus 50% sensitivity, 100% specificity and 66.7% accuracy for {sup 99m}Tc-HMPAO-leucocyte scintigraphy). These results demonstrate the feasibility of the avidin/{sup 111}In-biotin approach for imaging sites of infection/inflammation in the clinical setting. Although no systematic advantages of avidin/{sup 111}In-biotin scintigraphy were found versus {sup 99m}Tc-HMPAO leucocyte scintigraphy, the newer scintigraphic method is more practicable and involves lower biological risk for the operators. (orig.) With 3 figs., 2 tabs., 56 refs.

Orthopaedic Disorders in Myotonic Dystrophy Type 1: descriptive clinical study of 21 patients

Science.gov (United States)

2013-01-01

Background Myotonic Dystrophy Type 1 (DM1) is the most common form of hereditary myopathy presenting in adults. This autosomal-dominant systemic disorder is caused by a CTG repeat, demonstrating various symptoms. A mild, classic and congenital form can be distinguished. Often the quality of life is reduced by orthopaedic problems, such as muscle weakness, contractures, foot or spinal deformities, which limit patients’ mobility. The aim of our study was to gather information about the orthopaedic impairments in patients with DM1 in order to improve the medical care of patients, affected by this rare disease. Methods A retrospective clinical study was carried out including 21 patients (11 male and 10 female), all diagnosed with DM1 by genetic testing. All patients were seen during our special consultations for neuromuscular diseases, during which patients were interviewed and examined. We also reviewed surgery reports of our hospitalized patients. Results We observed several orthopaedic impairments: spinal deformities (scoliosis, hyperkyphosis, rigid spine), contractures (of the upper extremities and the lower extremities), foot deformities (equinus deformity, club foot, pes cavus, pes planovalgus, pes cavovarus, claw toes) and fractures. Five patients were affected by pulmonary diseases (obstructive airway diseases, restrictive lung dysfunctions). Twelve patients were affected by cardiac disorders (congenital heart defects, valvular heart defects, conduction disturbances, pulmonary hypertension, cardiomyopathy). Our patients received conservative therapy (physiotherapy, logopaedic therapy, ergotherapy) and we prescribed orthopaedic technical devices (orthopaedic custom-made shoes, insoles, lower and upper leg orthoses, wheelchair, Rehab Buggy). We performed surgery for spinal and foot deformities: the scoliosis of one patient was stabilized and seven patients underwent surgery for correction of foot deformities. Conclusions An orthopaedic involvement in DM1

Does sleep deprivation impair orthopaedic surgeons' cognitive and psychomotor performance?

Science.gov (United States)

O'Brien, Michael J; O'Toole, Robert V; Newell, Mary Zadnik; Lydecker, Alison D; Nascone, Jason; Sciadini, Marcus; Pollak, Andrew; Turen, Clifford; Eglseder, W Andrew

2012-11-07

Sleep deprivation may slow reaction time, cloud judgment, and impair the ability to think. Our purpose was to study the cognitive and psychomotor performances of orthopaedic trauma surgeons on the basis of the amount of sleep that they obtained. We prospectively studied the performances of thirty-two orthopaedic trauma surgeons (residents, fellows, and attending surgeons) over two four-week periods at an urban academic trauma center. Testing sessions used handheld computers to administer validated cognitive and psychomotor function tests. We conducted a multivariate analysis to examine the independent association between test performance and multiple covariates, including the amount of sleep the night before testing. Our analysis demonstrated that orthopaedic surgeons who had slept four hours or less the night before the test had 1.43 times the odds (95% confidence interval, 1.04 to 1.95; p = 0.03) of committing at least one error on an individual test compared with orthopaedic surgeons who had slept more than four hours the previous night. The Running Memory test, which assesses sustained attention, concentration, and working memory, was most sensitive to deterioration in performance in participants who had had four hours of sleep or less; when controlling for other covariates, the test demonstrated a 72% increase in the odds of making at least one error (odds ratio, 1.72 [95% confidence interval, 1.02 to 2.90]; p = 0.04). No significant decrease in performance with sleep deprivation was shown with the other three tests. Orthopaedic trauma surgeons showed deterioration in performance on a validated cognitive task when they had slept four hours or less the previous night. It is unknown how performance on this test relates to surgical performance.

ASSESSING THE AGREEMENT BETWEEN EO-BASED SEMI-AUTOMATED LANDSLIDE MAPS WITH FUZZY MANUAL LANDSLIDE DELINEATION

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F. Albrecht

2017-09-01

Full Text Available Landslide mapping benefits from the ever increasing availability of Earth Observation (EO data resulting from programmes like the Copernicus Sentinel missions and improved infrastructure for data access. However, there arises the need for improved automated landslide information extraction processes from EO data while the dominant method is still manual delineation. Object-based image analysis (OBIA provides the means for the fast and efficient extraction of landslide information. To prove its quality, automated results are often compared to manually delineated landslide maps. Although there is awareness of the uncertainties inherent in manual delineations, there is a lack of understanding how they affect the levels of agreement in a direct comparison of OBIA-derived landslide maps and manually derived landslide maps. In order to provide an improved reference, we present a fuzzy approach for the manual delineation of landslides on optical satellite images, thereby making the inherent uncertainties of the delineation explicit. The fuzzy manual delineation and the OBIA classification are compared by accuracy metrics accepted in the remote sensing community. We have tested this approach for high resolution (HR satellite images of three large landslides in Austria and Italy. We were able to show that the deviation of the OBIA result from the manual delineation can mainly be attributed to the uncertainty inherent in the manual delineation process, a relevant issue for the design of validation processes for OBIA-derived landslide maps.

A review of virtual reality based training simulators for orthopaedic surgery.

Science.gov (United States)

Vaughan, Neil; Dubey, Venketesh N; Wainwright, Thomas W; Middleton, Robert G

2016-02-01

This review presents current virtual reality based training simulators for hip, knee and other orthopaedic surgery, including elective and trauma surgical procedures. There have not been any reviews focussing on hip and knee orthopaedic simulators. A comparison of existing simulator features is provided to identify what is missing and what is required to improve upon current simulators. In total 11 hip replacements pre-operative planning tools were analysed, plus 9 hip trauma fracture training simulators. Additionally 9 knee arthroscopy simulators and 8 other orthopaedic simulators were included for comparison. The findings are that for orthopaedic surgery simulators in general, there is increasing use of patient-specific virtual models which reduce the learning curve. Modelling is also being used for patient-specific implant design and manufacture. Simulators are being increasingly validated for assessment as well as training. There are very few training simulators available for hip replacement, yet more advanced virtual reality is being used for other procedures such as hip trauma and drilling. Training simulators for hip replacement and orthopaedic surgery in general lag behind other surgical procedures for which virtual reality has become more common. Further developments are required to bring hip replacement training simulation up to date with other procedures. This suggests there is a gap in the market for a new high fidelity hip replacement and resurfacing training simulator. Copyright © 2015 IPEM. Published by Elsevier Ltd. All rights reserved.

EOS Terra Validation Program

Science.gov (United States)

Starr, David

2000-01-01

The EOS Terra mission will be launched in July 1999. This mission has great relevance to the atmospheric radiation community and global change issues. Terra instruments include Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER), Clouds and Earth's Radiant Energy System (CERES), Multi-Angle Imaging Spectroradiometer (MISR), Moderate Resolution Imaging Spectroradiometer (MODIS) and Measurements of Pollution in the Troposphere (MOPITT). In addition to the fundamental radiance data sets, numerous global science data products will be generated, including various Earth radiation budget, cloud and aerosol parameters, as well as land surface, terrestrial ecology, ocean color, and atmospheric chemistry parameters. Significant investments have been made in on-board calibration to ensure the quality of the radiance observations. A key component of the Terra mission is the validation of the science data products. This is essential for a mission focused on global change issues and the underlying processes. The Terra algorithms have been subject to extensive pre-launch testing with field data whenever possible. Intensive efforts will be made to validate the Terra data products after launch. These include validation of instrument calibration (vicarious calibration) experiments, instrument and cross-platform comparisons, routine collection of high quality correlative data from ground-based networks, such as AERONET, and intensive sites, such as the SGP ARM site, as well as a variety field experiments, cruises, etc. Airborne simulator instruments have been developed for the field experiment and underflight activities including the MODIS Airborne Simulator (MAS) AirMISR, MASTER (MODIS-ASTER), and MOPITT-A. All are integrated on the NASA ER-2 though low altitude platforms are more typically used for MASTER. MATR is an additional sensor used for MOPITT algorithm development and validation. The intensive validation activities planned for the first year of the Terra

II Italian intersociety consensus statement on antithrombotic prophylaxis in orthopaedics and traumatology: arthroscopy, traumatology, leg immobilization, minor orthopaedic procedures and spine surgery.

Science.gov (United States)

Randelli, F; Romanini, E; Biggi, F; Danelli, G; Della Rocca, G; Laurora, N R; Imberti, D; Palareti, G; Prisco, D

2013-03-01

Pharmacological prophylaxis for preventing venous thromboembolism (VTE) is a worldwide established procedure in hip and knee replacement surgery, as well as in the treatment of femoral neck fractures, but few data exist in other fields of orthopaedics and traumatology. Thus, no guidelines or recommendations are available in the literature except for a limited number of weak statements about knee arthroscopy and lower limb fractures. In any case, none of them are a multidisciplinary effort as the one here presented. The Italian Society for Studies on Haemostasis and Thrombosis (SISET), the Italian Society of Orthopaedics and Traumatology (SIOT), the Association of Orthopaedic Traumatology of Italian Hospitals (OTODI), together with the Italian Society of Anesthesia, Analgesia, Resuscitation and Intensive Care (SIAARTI) and the Italian Society of General Medicine (SIMG) have set down easy and quick suggestions for VTE prophylaxis in a number of surgical conditions for which only scarce evidence is available. This inter-society consensus statement aims at simplifying the approach to VTE prophylaxis in the single patient with the goal to improve its clinical application.

Spinal penetration index assessment in adolescent idiopathic scoliosis using EOS low-dose biplanar stereoradiography.

Science.gov (United States)

Ilharreborde, Brice; Dubousset, Jean; Skalli, Wafa; Mazda, Keyvan

2013-11-01

The spinal penetration index (SPI) quantifies the portion of the rib cage occupied by vertebrae. When measured by computed tomography (CT) or magnetic resonance imaging, SPI can only be determined in the reclining position, which modifies spinal and thoracic morphology. CT results in high radiation exposure. The authors studied rib cage and spinal morphology using low-dose biplanar stereoradiography and their impact on respiratory function in adolescent idiopathic scoliosis (AIS). In eighty thoracic AIS patients, a slot-scanning radiologic device allowing simultaneous acquisition of orthogonal images and 3D reconstructions with low exposure to radiation (EOS) was used to determine thoracic volume, mean spinal penetration index (SPIm), apical spinal penetration index (SPIa), main thoracic (MT) curve Cobb angle, T4-T12 kyphosis, and apical vertebral rotation (AVR). Thoracic volume was correlated with thoracic kyphosis (r = 0.31, p = 0.006), but not with SPI, MT Cobb angle, or AVR. SPIm and SPIa were negatively correlated with thoracic kyphosis. Forced vital capacity and forced expiratory volume in 1 s were significantly lower in the hypokyphotic patients (p = 0.04, p = 0.03, respectively) and correlated with thoracic volume and T4-T12 kyphosis. No correlation was found between spinal penetration indices and pulmonary function tests, but SPIm was significantly greater in patients with obstructive syndrome (p = 0.01). With little radiation exposure, EOS biplanar stereoradiography permits routine imaging is a functional standing position. Hypokyphotic patients had significantly decreased FEV1 and FVC. SPIm was significantly higher in patients with obstructive syndrome.

Reduction of metal artefacts in musculoskeletal imaging

International Nuclear Information System (INIS)

Sutter, Reto; Dietrich, Tobias

2016-01-01

Joint replacement and other orthopaedic implants are utilized in many patients with musculoskeletal disorders. While these operations commonly show a good clinical result, a substantial number of patients need to undergo postoperative imaging during follow-up. The presence of orthopaedic implants induces severe metal artefacts at MRI and CT. We review several basic methods and advanced techniques for reducing metal artefacts at MRI and CT in order to enable a diagnostic examination in patients with metal implants. With the use of these techniques, MRI and CT are important and reliable modalities to examine patients with joint replacement and orthopaedic implants.

Orthopaedic Sports Medicine Fellowship Interviews: Structure and Organization of the Interview Day.

Science.gov (United States)

Haislup, Brett D; Kraeutler, Matthew J; Baweja, Rishi; McCarty, Eric C; Mulcahey, Mary K

2017-12-01

Over the past few decades, there has been a trend toward an increasing subspecialization in orthopaedic surgery, with orthopaedic sports medicine being one of the most competitive subspecialties. Information regarding the application and interview process for sports medicine fellowships is currently lacking. To survey orthopaedic sports medicine fellowship program directors (PDs) to better define the structure of the sports medicine fellowship interview and to highlight important factors that PDs consider in selecting fellows. Cross-sectional study. A complete list of accredited programs was obtained from the American Orthopaedic Society for Sports Medicine (AOSSM) website. An anonymous survey was distributed to fellowship PDs of all Accreditation Council for Graduate Medical Education (ACGME)-accredited orthopaedic sports medicine fellowships in the United States. The survey included 12 questions about the fellowship interview and selection process. Of the 95 orthopaedic sports medicine fellowship PDs surveyed, 38 (40%) responded. Of these, 16 (42.1%) indicated that they interview between 21 and 30 applicants per year. Eleven of the 38 fellowship programs (28.9%) have only 1 fellow per year at their respective program. Most programs (27/37, 73%) reported that between 0 and 5 faculty members interview applicants, and 29 of the 38 programs (76.3%) arrange for applicants to have ≥4 interviews during their interview day. Large group interviews are conducted at 36 of 38 (94.7%) sports medicine fellowship programs, and most programs (24/38, 63.2%) hold individual interviews that last between 5 and 15 minutes. The most important applicant criterion taken into account by PDs was the quality of the interview, with an average score of 8.68 of 10. The most significant factor taken into account by PDs when deciding how to rank applicants was the quality of the interview. Many orthopaedic sports medicine fellowship programs interview between 21 and 30 applicants per year

High incidence of hemiarthroplasty for shoulder osteoarthritis among recently graduated orthopaedic surgeons.

Science.gov (United States)

Mann, Tobias; Baumhauer, Judith F; O'Keefe, Regis J; Harrast, John; Hurwitz, Shepard R; Voloshin, Ilya

2014-11-01

Primary glenohumeral osteoarthritis is a common indication for shoulder arthroplasty. Historically, both total shoulder arthroplasty (TSA) and hemi-shoulder arthroplasty (HSA) have been used to treat primary glenohumeral osteoarthritis. The choice between procedures is a topic of debate, with HSA proponents arguing that it is less invasive, faster, less expensive, and technically less demanding, with quality of life outcomes equivalent to those of TSA. More recent evidence suggests TSA is superior in terms of pain relief, function, ROM, strength, and patient satisfaction. We therefore investigated the practice of recently graduated orthopaedic surgeons pertaining to the surgical treatment of this disease. We hypothesized that (1) recently graduated, board eligible, orthopaedic surgeons with fellowship training in shoulder surgery are more likely to perform TSA than surgeons without this training; (2) younger patients are more likely to receive HSA than TSA; (3) patient sex affects the choice of surgery; (4) US geographic region affects practice patterns; and (5) complication rates for HSA and TSA are not different. We queried the American Board of Orthopaedic Surgery's database to identify practice patterns of orthopaedic surgeons taking their board examination. We identified 771 patients with primary glenohumeral osteoarthritis treated with TSA or HSA from 2006 to 2011. The rates of TSA and HSA were compared based on the treating surgeon's fellowship training, patient age and sex, US geographic region, and reported surgical complications. Surgeons with fellowship training in shoulder surgery were more likely (86% versus 72%; OR 2.32; 95% CI, 1.56-3.45, pguidelines for the treatment of glenohumeral osteoarthritis published by the American Academy of Orthopaedic Surgeons. These guidelines favor using TSA over HSA in the treatment of shoulder arthritis. Further investigation is needed to clarify if these practice patterns are isolated to recently graduated board

Worldwide orthopaedic research activity 2010-2014: Publication rates in the top 15 orthopaedic journals related to population size and gross domestic product.

Science.gov (United States)

Hohmann, Erik; Glatt, Vaida; Tetsworth, Kevin

2017-06-18

To perform a bibliometric analysis of publications rates in orthopedics in the top 15 orthopaedic journals. Based on their 2015 impact factor, the fifteen highest ranked orthopaedic journals between January 2010 and December 2014 were used to establish the total number of publications; cumulative impact factor points (IF) per country were determined, and normalized to population size, GDP, and GDP/capita, comparison to the median country output and the global leader. Twenty-three thousand and twenty-one orthopaedic articles were published, with 66 countries publishing. The United States had 8149 publications, followed by the United Kingdom (1644) and Japan (1467). The highest IF was achieved by the United States (24744), United Kingdom (4776), and Japan (4053). Normalized by population size Switzerland lead. Normalized by GDP, Croatia was the top achiever. Adjusting GDP/capita, for publications and IF, China, India, and the United States were the leaders. Adjusting for population size and GDP, 28 countries achieved numbers of publications to be considered at least equivalent with the median academic output. Adjusting GDP/capita only China and India reached the number of publications to be considered equivalent to the current global leader, the United States. Five countries were responsible for 60% of the orthopaedic research output over this 5-year period. After correcting for GDP/capita, only 28 of 66 countries achieved a publication rate equivalent to the median country. The United States, United Kingdom, South Korea, Japan, and Germany were the top five countries for both publication totals and cumulative impact factor points.

Barriers and facilitators experienced in collaborative prospective research in orthopaedic oncology

DEFF Research Database (Denmark)

Rendon, J S; Swinton, M; Bernthal, N

2017-01-01

by orthopaedic oncological surgeons involved or interested in prospective multicentre collaboration. METHODS: All surgeons who were involved, or had expressed an interest, in the ongoing Prophylactic Antibiotic Regimens in Tumour Surgery (PARITY) trial were invited to participate in a focus group to discuss......: The 13 surgeons who participated in the discussion represented orthopaedic oncology practices from seven countries (Argentina, Brazil, Italy, Spain, Denmark, United States and Canada). Four categories and associated themes emerged from the discussion: the need for collaboration in the field...... of orthopaedic oncology due to the rarity of the tumours and the need for high level evidence to guide treatment; motivational factors for participating in collaborative research including establishing proof of principle, learning opportunity, answering a relevant research question and being part...

Evaluation of the orthopaedics and traumatology resident education in Turkey: A descriptive study.

Science.gov (United States)

Huri, Gazi; Cabuk, Yusuf Sertan; Gursoy, Safa; Akkaya, Mustafa; Ozkan, Secil; Oztuna, Volkan; Aydingoz, Onder; Senkoylu, Alparslan

2016-10-01

The objective of this study is to describe the current situation regarding the training, working conditions, future plans, fields of interest and satisfaction of orthopaedics and traumatology residents in Turkey. A descriptive survey questionnaire consisting of 24 questions was designed to identify the problems and solution suggestions concerning training of orthopaedic residents. All orthopaedics and traumatology residents who took the 2013 Progress Testing for Speciality in Medicine (UEGS) held by Turkish Orthopaedics and Traumatology Education Council (TOTEK) were surveyed in the class at the end thereof as well as the young orthopaedic surgeons who were reached through the email groups of Turkish Society of Orthopaedics and Traumatology - Residents and Young Attendings Council (TOTBID-AGUH). A total of 725 residents and 132 young attendings were surveyed. The most outstanding answers are as follows: 62,7% of the respondents replied to the question "Is there a training program/Is it being applied" as "yes/yes". It was found out that 94,3% of the respondents wanted to be involved in a rotation abroad. The "patient care" was the most common answer, with a ratio of 36,9%, to the question "What's the priority of the department you are studying in?". Regarding work conditions, "many emergency on-calls" was found to be the most important parameter affecting life conditions (p traumatology residents in Turkey face as regards their training, this survey stands as a pioneering study with a high participation rate. Analysis of survey data highlights the importance of several key factors such as the development of training programs and increasing the time spent with academicians as well as spreading and promotion of log book application. Copyright © 2016 Turkish Association of Orthopaedics and Traumatology. Production and hosting by Elsevier B.V. All rights reserved.

Development of a THz spectroscopic imaging system

International Nuclear Information System (INIS)

Usami, M; Iwamoto, T; Fukasawa, R; Tani, M; Watanabe, M; Sakai, K

2002-01-01

We have developed a real-time THz imaging system based on the two-dimensional (2D) electro-optic (EO) sampling technique. Employing the 2D EO-sampling technique, we can obtain THz images using a CCD camera at a video rate of up to 30 frames per second. A spatial resolution of 1.4 mm was achieved. This resolution was reasonably close to the theoretical limit determined by diffraction. We observed not only static objects but also moving ones. To acquire spectroscopic information, time-domain images were collected. By processing these images on a computer, we can obtain spectroscopic images. Spectroscopy for silicon wafers was demonstrated

Distribution of MEG and methanol in well-defined hydrocarbon and water systems: Experimental measurement and modeling using the CPA EoS

DEFF Research Database (Denmark)

Riaz, Muhammad; Yussuf, Mustafe A.; Kontogeorgis, Georgios

2013-01-01

+ water. These data are satisfactorily correlated (binaries) and predicted (ternaries) using Cubic Plus Association (CPA) equation of state (EoS). CPA is also applied to binary LLE of aromatic hydrocarbon + water and VLE of methane + methanol. Finally the distribution of water and inhibitors (methanol...... and MEG) in various phases is modeled using CPA. The hydrocarbon phase consists of mixture-1 (methane, ethane, n-butane) or mixture-2 (methane, ethane, propane, n-butane, n-heptane, toluene and n-decane). CPA can satisfactorily predict the water content in the gas phase of the multicomponent systems...

Does Residency Selection Criteria Predict Performance in Orthopaedic Surgery Residency?

Science.gov (United States)

Raman, Tina; Alrabaa, Rami George; Sood, Amit; Maloof, Paul; Benevenia, Joseph; Berberian, Wayne

2016-04-01

More than 1000 candidates applied for orthopaedic residency positions in 2014, and the competition is intense; approximately one-third of the candidates failed to secure a position in the match. However, the criteria used in the selection process often are subjective and studies have differed in terms of which criteria predict either objective measures or subjective ratings of resident performance by faculty. Do preresidency selection factors serve as predictors of success in residency? Specifically, we asked which preresidency selection factors are associated or correlated with (1) objective measures of resident knowledge and performance; and (2) subjective ratings by faculty. Charts of 60 orthopaedic residents from our institution were reviewed. Preresidency selection criteria examined included United States Medical Licensing Examination (USMLE) Step 1 and Step 2 scores, Medical College Admission Test (MCAT) scores, number of clinical clerkship honors, number of letters of recommendation, number of away rotations, Alpha Omega Alpha (AOA) honor medical society membership, fourth-year subinternship at our institution, and number of publications. Resident performance was assessed using objective measures including American Board of Orthopaedic Surgery (ABOS) Part I scores and Orthopaedics In-Training Exam (OITE) scores and subjective ratings by faculty including global evaluation scores and faculty rankings of residents. We tested associations between preresidency criteria and the subsequent objective and subjective metrics using linear correlation analysis and Mann-Whitney tests when appropriate. Objective measures of resident performance namely, ABOS Part I scores, had a moderate linear correlation with the USMLE Step 2 scores (r = 0.55, p communication skills" subsection of the global evaluations. We found that USMLE Step 2, number of honors in medical school clerkships, and AOA membership demonstrated the strongest correlations with resident performance. Our

SU-D-204-06: Dose and Image Quality Evaluation of a Low-Dose Slot-Scanning X-Ray System for Pediatric Orthopedic Studies

Energy Technology Data Exchange (ETDEWEB)

Liu, Z; Hoerner, M; Lamoureux, R; Rill, L; Arreola, M [Univ Florida, Jacksonville Beach, FL (United States)

2015-06-15

Purpose: Children in early teens with scoliosis require repeated radiographic exams over a number of years. The EOS (EOS imaging S.A., Paris, France) is a novel low-dose slot-scanning digital radiographic system designed to produce full-spine images of a free-standing patient. The radiation dose and image quality characteristics of the EOS were evaluated relative to those of a Computed Radiography (CR) system for scoliosis imaging. Methods: For dose evaluation, a full-torso anthropomorphic phantom was scanned five times using the default standard clinical protocols for both the EOS and a CR system, which include both posteroanterior and lateral full-spine views. Optically stimulated luminescent dosimeters (OSLDs), also known as nanoDots™ (Landauer, Inc., Glenwood, IL), were placed on the phantom’s surface to measure entrance skin dose. To assess image quality, MTF curves were generated from sampling the noise levels within the high-contrast regions of a line-pair phantom. Vertical and horizontal distortions were measured for the square line-pair phantom with the EOS system to evaluate the effects of geometric magnification and misalignment with the indicated imaging plane. Results: The entrance skin dose was measured to be 0.4 to 1.1 mGy for the EOS, and 0.7 to 3.6 mGy for the CR study. MTF comparison shows that CR greatly outperforms the EOS, despite both systems having a limiting resolution at 1.8 line-pairs per mm. Vertical distortion was unaffected by phantom positioning, because of the EOS slot-scanning geometry. Horizontal distortion increased linearly with miscentering distance. Conclusion: The EOS system resulted in approximately 70% lower radiation dose than CR for full-spine images. Image quality was found to be inferior to CR. Further investigation is required to see if EOS system is an acceptable modality for performing clinically diagnostic scoliosis examinations.

SU-D-204-06: Dose and Image Quality Evaluation of a Low-Dose Slot-Scanning X-Ray System for Pediatric Orthopedic Studies

International Nuclear Information System (INIS)

Liu, Z; Hoerner, M; Lamoureux, R; Rill, L; Arreola, M

2015-01-01

Purpose: Children in early teens with scoliosis require repeated radiographic exams over a number of years. The EOS (EOS imaging S.A., Paris, France) is a novel low-dose slot-scanning digital radiographic system designed to produce full-spine images of a free-standing patient. The radiation dose and image quality characteristics of the EOS were evaluated relative to those of a Computed Radiography (CR) system for scoliosis imaging. Methods: For dose evaluation, a full-torso anthropomorphic phantom was scanned five times using the default standard clinical protocols for both the EOS and a CR system, which include both posteroanterior and lateral full-spine views. Optically stimulated luminescent dosimeters (OSLDs), also known as nanoDots™ (Landauer, Inc., Glenwood, IL), were placed on the phantom’s surface to measure entrance skin dose. To assess image quality, MTF curves were generated from sampling the noise levels within the high-contrast regions of a line-pair phantom. Vertical and horizontal distortions were measured for the square line-pair phantom with the EOS system to evaluate the effects of geometric magnification and misalignment with the indicated imaging plane. Results: The entrance skin dose was measured to be 0.4 to 1.1 mGy for the EOS, and 0.7 to 3.6 mGy for the CR study. MTF comparison shows that CR greatly outperforms the EOS, despite both systems having a limiting resolution at 1.8 line-pairs per mm. Vertical distortion was unaffected by phantom positioning, because of the EOS slot-scanning geometry. Horizontal distortion increased linearly with miscentering distance. Conclusion: The EOS system resulted in approximately 70% lower radiation dose than CR for full-spine images. Image quality was found to be inferior to CR. Further investigation is required to see if EOS system is an acceptable modality for performing clinically diagnostic scoliosis examinations

Advancements in medium and high resolution Earth observation for land-surface imaging: Evolutions, future trends and contributions to sustainable development

Science.gov (United States)

Ouma, Yashon O.

2016-01-01

Technologies for imaging the surface of the Earth, through satellite based Earth observations (EO) have enormously evolved over the past 50 years. The trends are likely to evolve further as the user community increases and their awareness and demands for EO data also increases. In this review paper, a development trend on EO imaging systems is presented with the objective of deriving the evolving patterns for the EO user community. From the review and analysis of medium-to-high resolution EO-based land-surface sensor missions, it is observed that there is a predictive pattern in the EO evolution trends such that every 10-15 years, more sophisticated EO imaging systems with application specific capabilities are seen to emerge. Such new systems, as determined in this review, are likely to comprise of agile and small payload-mass EO land surface imaging satellites with the ability for high velocity data transmission and huge volumes of spatial, spectral, temporal and radiometric resolution data. This availability of data will magnify the phenomenon of ;Big Data; in Earth observation. Because of the ;Big Data; issue, new computing and processing platforms such as telegeoprocessing and grid-computing are expected to be incorporated in EO data processing and distribution networks. In general, it is observed that the demand for EO is growing exponentially as the application and cost-benefits are being recognized in support of resource management.

Orthopaedic podiatry triage: process outcomes of a skill mix initiative.

Science.gov (United States)

Homeming, Lyndon J; Kuipers, Pim; Nihal, Aneel

2012-11-01

The Orthopaedic Podiatry Triage Clinic (OPodTC) is a 'skill mix' model of care developed in Queensland Health to address the problem of lengthy waiting times for orthopaedic surgery on foot and ankle pathologies. It is based on the recognition that many orthopaedic surgery referrals can be identified early and treated conservatively with podiatry, averting the need for more costly and invasive surgical interventions. The model is collaborative and relies on screening and triage by the podiatrist, rather than delegation by the orthopaedic surgeon. Screening and triage through OPodTC was trialled at three Queensland Health hospital facilities during 2009 and 2010 to improve service timeliness. Patients identified by the OPodTC podiatrist as suitable for conservative management were provided with non-surgical podiatry interventions and discharged if appropriate. Those identified as still requiring surgical intervention after the benefit of interim conservative treatment provided by the podiatrist (or who chose to remain on the list) were returned to their previous place on the orthopaedic waiting list. This paper presents a summary and description of waiting list changes in association with this trial. The OPodTC intervention resulted in a reduction in the non-urgent category of the waiting list across the three hospitals of between 23.3% and 49.7%. Indications from wait-list service data demonstrated increased timeliness and improved patient flow, which are core goals of these skill mix initiatives. This study highlights the potential of screening and triage functions in the skill mix debate. In this example, conservative treatment options were considered first, suitable patients did not have to wait long periods to receive timely and appropriate interventions, and those for whom surgery was indicated, were provided with a more targeted service.

Understanding how orthopaedic surgery practices generate value for healthcare systems.

Science.gov (United States)

Olson, Steven A; Mather, Richard C

2013-06-01

Orthopaedic surgery practices can provide substantial value to healthcare systems. Increasingly, healthcare administrators are speaking of the need for alignment between physicians and healthcare systems. However, physicians often do not understand what healthcare administrators value and therefore have difficulty articulating the value they create in discussions with their hospital or healthcare organization. Many health systems and hospitals use service lines as an organizational structure to track the relevant data and manage the resources associated with a particular type of care, such as musculoskeletal care. Understanding service lines and their management can be useful for orthopaedic surgeons interested in interacting with their hospital systems. We provide an overview of two basic types of value orthopaedic surgeons create for healthcare systems: financial or volume-driven benefits and nonfinancial quality or value-driven patient care benefits. We performed a search of PubMed from 1965 to 2012 using the term "service line." Of the 351 citations identified, 18 citations specifically involved the use of service lines to improve patient care in both nursing and medical journals. A service line is a structure used in healthcare organizations to enable management of a subset of activities or resources in a focused area of patient care delivery. There is not a consistent definition of what resources are managed within a service line from hospital to hospital. Physicians can positively impact patient care through engaging in service line management. There is increasing pressure for healthcare systems and hospitals to partner with orthopaedic surgeons. The peer-reviewed literature demonstrates there are limited resources for physicians to understand the value they create when attempting to negotiate with their hospital or healthcare organization. To effectively negotiate for resources to provide the best care for patients, orthopaedic surgeons need to claim and

Molecular Solid EOS based on Quasi-Harmonic Oscillator approximation for phonons

Energy Technology Data Exchange (ETDEWEB)

Menikoff, Ralph [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2014-09-02

A complete equation of state (EOS) for a molecular solid is derived utilizing a Helmholtz free energy. Assuming that the solid is nonconducting, phonon excitations dominate the specific heat. Phonons are approximated as independent quasi-harmonic oscillators with vibrational frequencies depending on the specific volume. The model is suitable for calibrating an EOS based on isothermal compression data and infrared/Raman spectroscopy data from high pressure measurements utilizing a diamond anvil cell. In contrast to a Mie-Gruneisen EOS developed for an atomic solid, the specific heat and Gruneisen coefficient depend on both density and temperature.

Complementarity of EO and radar systems

NARCIS (Netherlands)

Schwering, P.B.W.

2001-01-01

Electro-optics (EO), including infrared, systems have matured in the last decades, allowing for a wider variation of applications. In particular, developments in detector capability and signal processing have resulted in autonomous detection systems as well as surveillance systems for situational

Status of the Multi-Angle SpectroRadiometer Instrument for EOS- AM1 and Its Application to Remote Sensing of Aerosols

Science.gov (United States)

Diner, D. J.; Abdou, W. A.; Bruegge, C. J.; Conel, J. E.; Kahn, R. A.; Martonchik, J. V.; Paradise, S. R.; West, R. A.

1995-01-01

The Multi-Angle Imaging SpectroRadiometer (MISR) is being developed at JPL for the AM1 spacecraft in the Earth Observing System (EOS) series. This paper reports on the progress of instrument fabrication and testing, and it discusses the strategy to use the instrument for studying tropospheric aerosols.

Evaluating the outcomes of a podiatry-led assessment service in a public hospital orthopaedic unit.

Science.gov (United States)

Bonanno, Daniel R; Medica, Virginia G; Tan, Daphne S; Spring, Anita A; Bird, Adam R; Gazarek, Jana

2014-01-01

In Australia, the demand for foot and ankle orthopaedic services in public health settings currently outweighs capacity. Introducing experienced allied health professionals into orthopaedic units to initiate the triage, assessment and management of patients has been proposed to help meet demand. The aim of this study was to evaluate the effect of introducing a podiatry-led assessment service in a public hospital orthopaedic unit. The outcomes of interest were determining: the proportion of patients discharged without requiring an orthopaedic appointment, agreement in diagnosis between the patient referral and the assessing podiatrist, the proportion of foot and ankle conditions presenting to the service, and the proportion of each condition to require an orthopaedic appointment. This study audited the first 100 patients to receive an appointment at a new podiatry-led assessment service. The podiatrist triaged 'Category 3' referrals consisting of musculoskeletal foot and ankle conditions and appointments were provided for those considered likely to benefit from non-surgical management. Following assessment, patients were referred to an appropriate healthcare professional or were discharged. At the initial appointment or following a period of care, patients were discharged if non-surgical management was successful, surgery was not indicated, patients did not want surgery, and if patient's failed to attend their appointments. All other patients were referred for an orthopaedic consultation as indicated. Ninety-five of the 100 patients (69 females and 31 males; mean age 51.9, SD 16.4 years) attended their appointment at the podiatry-led assessment service. The 95 referrals contained a total of 107 diagnoses, of which the podiatrist agreed with the diagnosis stated on the referral in 56 cases (Kappa =0.49, SE = 0.05). Overall, 34 of the 100 patients were referred to an orthopaedic surgeon and the remaining 66 patients were discharged from the orthopaedic waiting

National Institutes of Health Funding to Departments of Orthopaedic Surgery at U.S. Medical Schools.

Science.gov (United States)

Silvestre, Jason; Ahn, Jaimo; Levin, L Scott

2017-01-18

The National Institutes of Health (NIH) is the largest supporter of biomedical research in the U.S., yet its contribution to orthopaedic research is poorly understood. In this study, we analyzed the portfolio of NIH funding to departments of orthopaedic surgery at U.S. medical schools. The NIH RePORT (Research Portfolio Online Reporting Tools) database was queried for NIH grants awarded to departments of orthopaedic surgery in 2014. Funding totals were determined for award mechanisms and NIH institutes. Trends in NIH funding were determined for 2005 to 2014 and compared with total NIH extramural research funding. Funding awarded to orthopaedic surgery departments was compared with that awarded to departments of other surgical specialties in 2014. Characteristics of NIH-funded principal investigators were obtained from department web sites. In 2014, 183 grants were awarded to 132 investigators at 44 departments of orthopaedic surgery. From 2005 to 2014, NIH funding increased 24.3%, to $54,608,264 (p = 0.030), but the rates of increase seen did not differ significantly from those of NIH extramural research funding as a whole (p = 0.141). Most (72.6%) of the NIH funding was awarded through the R01 mechanism, with a median annual award of $343,980 (interquartile range [IQR], $38,372). The majority (51.1%) of the total funds supported basic science research, followed by translational (33.0%), clinical (10.0%), and educational (5.9%) research. NIH-funded orthopaedic principal investigators were predominately scientists whose degree was a PhD (71.1%) and who were male (79.5%). Eleven NIH institutes were represented, with the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) providing the preponderance (74.2%) of the funding. In 2014, orthopaedic surgery ranked below the surgical departments of general surgery, ophthalmology, obstetrics and gynecology, otolaryngology, and urology in terms of NIH funding received. The percentage increase of NIH

The Malaysian Orthopaedic Association humanitarian mission to Indonesia and Sri Lanka.

Science.gov (United States)

Sharaf, I; Saw, A; Hyzan, Y; Sivananthan, K S

2005-07-01

The tsunami which occurred off the west coast of North Sumatra on December 26, 2004 devastated the coastal areas of North Sumatra, South-West Thailand, South-East India and Sri Lanka killing more than a quarter of a million people. The destruction was enormous with many coastal villages destroyed. The other countries affected were Malaysia, Myanmar, Maldives, Bangladesh, Somalia, Kenya, Tanzania and the Seychelles. In January 2005, volunteers went in weekly rotation to Banda Aceh in collaboration with Global Peace Mission. These were Dr Hyzan Yusof, Dr Suryasmi Duski, Dr Sharaf Ibrahim, Dr Saw Aik, Dr Kamariah Nor and Dr Nor Azlin. In Banda Aceh, the surgical procedures that we could do were limited to external fixation of open fractures and debriding infected wounds at the Indonesian Red Crescent field hospital. In February, a team comprising Dato Dr K S Sivananthan, Dr T Kumar and Dr S Vasan spent a week in Sri Lanka. In Sri Lanka, Dato Sivananthan and his team were able to perform elective orthopaedic operations in Dr Poonambalam Memorial Hospital. We appealed for national and international aid and received support from local hospitals and the orthopaedic industry. International aid bound for Banda Aceh arrived in Kuala Lumpur from the Philippine Orthopaedic Association, the Chiba Children's Hospital in Japan and the Chinese Orthopaedic Association. The COA donated 1.5 tons of orthopaedic equipments. A special handing over ceremony from the COA to the Indonesian Orthopaedic Association was held in Putrajaya in March. Malaysia Airlines flew in the donated equipment to Kuala Lumpur while the onward flight to Aceh was provided by the Royal Malaysian Air Force. In April, Dr Saw Aik and Dr Yong Su Mei joined the Tsu-Chi International Medical Association for volunteer services on Batam Island, Indonesia. The MOA acknowledges the many individuals and organizations, both governmental and non-governmental, for their contributions in the humanitarian efforts.

NASA's Earth Observing System (EOS): Delivering on the Dream, Today and Tomorrow

Science.gov (United States)

Kelly, Angelita C.; Johnson, Patricia; Case, Warren F.

2010-01-01

This paper describes the successful operations of NASA's Earth Observing System (EOS) satellites over the past 10 years and the plans for the future. Excellent operations performance has been a key factor in the overall success of EOS. The EOS Program was conceived in the 1980s and began to take shape in the early 1990s. EOS consists of a series of satellites that study the Earth as an interrelated system. It began with the launch of Terra in December 1999, followed by Aqua in May 2002, and Aura in July 2004. A key EOS goal is to provide a long-term continuous data set to enable the science community to develop a better understanding of land, ocean, and atmospheric processes and their interactions. EOS has produced unprecedented amounts of data which are used all over the world free of charge. Mission operations have resulted in data recovery for Terra, Aqua, and Aura that have consistently exceeded mission requirements. The paper describes the ground systems and organizations that control the EOS satellites, capture the raw data, and distribute the processed science data sets. The paper further describes how operations have evolved since 1999. Examples of this evolution include (a) the implementation of new mission safety requirements for orbital debris monitoring; (b) technology upgrades to keep facilities at the state of the art; (c) enhancements to meet changing security requirements; and (d) operations management of the 2 international Earth Observing Constellations of 11 satellites known as the "Morning Constellation" and the "A-Train". The paper concludes with a view into the future based on the latest spacecraft status, lifetime projections, and mission plans.

Regenerative orthopaedics: in vitro, in vivo...in silico.

Science.gov (United States)

Geris, Liesbet

2014-09-01

In silico, defined in analogy to in vitro and in vivo as those studies that are performed on a computer, is an essential step in problem-solving and product development in classical engineering fields. The use of in silico models is now slowly easing its way into medicine. In silico models are already used in orthopaedics for the planning of complicated surgeries, personalised implant design and the analysis of gait measurements. However, these in silico models often lack the simulation of the response of the biological system over time. In silico models focusing on the response of the biological systems are in full development. This review starts with an introduction into in silico models of orthopaedic processes. Special attention is paid to the classification of models according to their spatiotemporal scale (gene/protein to population) and the information they were built on (data vs hypotheses). Subsequently, the review focuses on the in silico models used in regenerative orthopaedics research. Contributions of in silico models to an enhanced understanding and optimisation of four key elements-cells, carriers, culture and clinics-are illustrated. Finally, a number of challenges are identified, related to the computational aspects but also to the integration of in silico tools into clinical practice.

State Variation in Medicaid Reimbursements for Orthopaedic Surgery.

Science.gov (United States)

Lalezari, Ramin M; Pozen, Alexis; Dy, Christopher J

2018-02-07

Medicaid reimbursements are determined by each state and are subject to variability. We sought to quantify this variation for commonly performed inpatient orthopaedic procedures. The 10 most commonly performed inpatient orthopaedic procedures, as ranked by the Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample, were identified for study. Medicaid reimbursement amounts for those procedures were benchmarked to state Medicare reimbursement amounts in 3 ways: (1) ratio, (2) dollar difference, and (3) dollar difference divided by the relative value unit (RVU) amount. Variability was quantified by determining the range and coefficient of variation for those reimbursement amounts. The range of variability of Medicaid reimbursements among states exceeded $1,500 for all 10 procedures. The coefficients of variation ranged from 0.32 (hip hemiarthroplasty) to 0.57 (posterior or posterolateral lumbar interbody arthrodesis) (a higher coefficient indicates greater variability), compared with 0.07 for Medicare reimbursements for all 10 procedures. Adjusted as a dollar difference between Medicaid and Medicare per RVU, the median values ranged from -$8/RVU (total knee arthroplasty) to -$17/RVU (open reduction and internal fixation of the femur). Variability of Medicaid reimbursement for inpatient orthopaedic procedures among states is substantial. This variation becomes especially remarkable given recent policy shifts toward focusing reimbursements on value.

Surgical skills simulation in trauma and orthopaedic training.

Science.gov (United States)

Stirling, Euan R B; Lewis, Thomas L; Ferran, Nicholas A

2014-12-19

Changing patterns of health care delivery and the rapid evolution of orthopaedic surgical techniques have made it increasingly difficult for trainees to develop expertise in their craft. Working hour restrictions and a drive towards senior led care demands that proficiency be gained in a shorter period of time whilst requiring a greater skill set than that in the past. The resulting conflict between service provision and training has necessitated the development of alternative methods in order to compensate for the reduction in 'hands-on' experience. Simulation training provides the opportunity to develop surgical skills in a controlled environment whilst minimising risks to patient safety, operating theatre usage and financial expenditure. Many options for simulation exist within orthopaedics from cadaveric or prosthetic models, to arthroscopic simulators, to advanced virtual reality and three-dimensional software tools. There are limitations to this form of training, but it has significant potential for trainees to achieve competence in procedures prior to real-life practice. The evidence for its direct transferability to operating theatre performance is limited but there are clear benefits such as increasing trainee confidence and familiarity with equipment. With progressively improving methods of simulation available, it is likely to become more important in the ongoing and future training and assessment of orthopaedic surgeons.

Development, implementation and evaluation of a patient handoff tool to improve safety in orthopaedic surgery.

Science.gov (United States)

Gagnier, Joel J; Derosier, Joseph M; Maratt, Joseph D; Hake, Mark E; Bagian, James P

2016-06-01

To develop, implement and test the effect of a handoff tool for orthopaedic trauma residents that reduces adverse events associated with the omission of critical information and the transfer of erroneous information. Components of this project included a literature review, resident surveys and observations, checklist development and refinement, implementation and evaluation of impact on adverse events through a chart review of a prospective cohort compared with a historical control group. Large teaching hospital. Findings of a literature review were presented to orthopaedic residents, epidemiologists, orthopaedic surgeons and patient safety experts in face-to-face meetings, during which we developed and refined the contents of a resident handoff tool. The tool was tested in an orthopaedic trauma service and its impact on adverse events was evaluated through a chart review. The handoff tool was developed and refined during the face-to-face meetings and a pilot implementation. Adverse event data were collected on 127 patients (n = 67 baseline period; n = 60 test period). A handoff tool for use by orthopaedic residents. Adverse events in patients handed off by orthopaedic trauma residents. After controlling for age, gender and comorbidities, testing resulted in fewer events per person (25-27% reduction; P < 0.10). Preliminary evidence suggests that our resident handoff tool may contribute to a decrease in adverse events in orthopaedic patients. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

A European Collaborative EO Summer School for the Education of Undergraduate and Masters Level Students- FORMAT-EO

Science.gov (United States)

Graves, Rosemarie; Remedios, John; Tramutoli, Valerio; Gil, Artur; Cuca, Branka

2014-05-01

An Erasmus intensive programme has been successfully funded to run a Europe-lead summer school in Earth Observation for the years 2013 and 2014. The summer school, FORMAT-EO (FORmation of Multi-disciplinary Approaches to Training in Earth Observation) has been proposed and implemented by a consortium of eight partner institutions from five European countries. The consortium was facilitated through the NEREUS network. In the summer of 2013, 21 students from seven European institutions took part in the two week intensive course which involved a total of 28 teachers from six institutions. Students were from a variety of backgrounds including aeronautical engineering MSc students and PhD students in the areas of marine biology, earthquake engineering and measurement of trace gases in the atmosphere. The aims of FORMAT-EO were: To give students exposure to the wider applications of Earth Observation To highlight the interdisciplinary, collaborative and international nature of Earth Observation To offer an intensive course to better equip students with specialist skills required for a career in this field To provide expert advice on the development of careers in the EO market Partners were invited not only to recruit students for the course but to also teach at the school based on their specific area of expertise. This approach to the teaching provided a timetable which was wide-ranging and covered topics from EU policies for Earth Observation to fire detection from space and an introduction to interaction between radiation and matter. An important aspect of the course was the interactive nature of much of the teaching. A topic was introduced to the students through a lecture followed by an interactive tutorial providing students with hands-on experience of working with EO data and specialist software. The final days of the summer school were spent on group project work which required students to use all of the skills that they acquired during the course to challenge a

The spectrum of orthopaedics at Chris Hani Baragwanath Academic Hospital

OpenAIRE

Pillay, J; Ramokgopa, MT

2013-01-01

Chris Hani Baragwanath Academic Hospital (CHBAH) is the third largest hospital in the world and is the largest in the Southern hemisphere, serving a population of more than 3.5 million people.¹ The purpose of this review is to identify the orthopaedic-related health events that occur within the population being serviced by the hospital, and in doing so provide a tool to be used for improving orthopaedic-related patient care and outcomes in public health services.² We also took special interes...

Orthopaedic nurses' perception of research utilization - A cross sectional survey

DEFF Research Database (Denmark)

Berthelsen, Connie Bøttcher; Hølge-Hazelton, Bibi

2015-01-01

The call for evidence-based knowledge in clinical nursing practice has increased during recent decades and research in orthopaedic nursing is needed to improve patients' conditions, care and treatment. A descriptive cross-sectional survey was conducted to determine the self-perceived theoretical....... The results indicated that despite the majority of orthopaedic nurses having low self-perceived theoretical knowledge and practical research competencies, their interest and motivation to improve these were high, especially their inner motivation. However, the nurses' inner motivation was inhibited by a lack...

Burnout and quality of life among orthopaedic trainees in a modern educational programme

NARCIS (Netherlands)

van Vendeloo, S. N.; Brand, P. L. P.; Verheyen, C. C. P. M.

We aimed to determine quality of life and burnout among Dutch orthopaedic trainees following a modern orthopaedic curriculum, with strict compliance to a 48-hour working week. We also evaluated the effect of the clinical climate of learning on their emotional wellbeing. We assessed burnout, quality

Aspirin for Prophylaxis Against Venous Thromboembolism After Orthopaedic Oncologic Surgery.

Science.gov (United States)

Mendez, Gregory M; Patel, Yash M; Ricketti, Daniel A; Gaughan, John P; Lackman, Richard D; Kim, Tae Won B

2017-12-06

Patients who undergo orthopaedic oncologic surgical procedures are at increased risk of developing a venous thromboembolism (VTE). Guidelines from surgical societies are shifting to include aspirin as a postoperative VTE prophylactic agent. The purpose of this study was to review our experience using aspirin as postoperative VTE prophylaxis for orthopaedic oncologic surgical procedures. This study was a retrospective review of patients diagnosed with a primary malignant soft-tissue or bone tumor or metastatic carcinoma. Demographic information, histopathologic diagnosis, VTE history, surgical procedure, and VTE prophylaxis were analyzed. VTE rates in the overall and prophylactic-specific cohorts were recorded and compared. A total of 142 distinct surgical procedures in 130 patients were included. VTE prophylaxis with aspirin was used after 103 procedures, and non-aspirin prophylaxis was used after 39. In 33 cases, imaging was used to investigate for VTE because of clinical signs and symptoms. VTE developed after 7 (4.9%) of the 142 procedures. There were 6 deep venous thromboses (DVTs) and 1 pulmonary embolism, and 2 of the VTEs presented in patients with a VTE history. VTE developed in 2.9% (3) of the 103 aspirin cases and 10.3% (4) of the 39 non-aspirin cases. No patient in the aspirin group who had been diagnosed with metastatic carcinoma, malignant soft-tissue sarcoma, lymphoma, or multiple myeloma developed a VTE. Risk factors for VTE development included diabetes mellitus (odds ratio [OR] = 10.40, 95% confidence interval [CI] = 1.61 to 67.30), a history of VTE (OR = 7.26, 95% CI = 1.19 to 44.25), postoperative transfusion (OR = 34.50, 95% CI = 3.94 to 302.01), and estimated blood losses of 250 mL (OR = 1.50, 95% CI = 1.11 to 2.03), 500 mL (OR = 2.26, 95% CI = 1.23 to 4.13), and 1,000 mL (OR = 5.10, 95% CI = 1.52 to 17.04). Aspirin may be a suitable and effective option for VTE chemoprophylaxis in patients treated with orthopaedic oncologic surgery, especially

Decellularized Tissue and Cell-Derived Extracellular Matrices as Scaffolds for Orthopaedic Tissue Engineering

Science.gov (United States)

Cheng, Christina W.; Solorio, Loran D.; Alsberg, Eben

2014-01-01

The reconstruction of musculoskeletal defects is a constant challenge for orthopaedic surgeons. Musculoskeletal injuries such as fractures, chondral lesions, infections and tumor debulking can often lead to large tissue voids requiring reconstruction with tissue grafts. Autografts are currently the gold standard in orthopaedic tissue reconstruction; however, there is a limit to the amount of tissue that can be harvested before compromising the donor site. Tissue engineering strategies using allogeneic or xenogeneic decellularized bone, cartilage, skeletal muscle, tendon and ligament have emerged as promising potential alternative treatment. The extracellular matrix provides a natural scaffold for cell attachment, proliferation and differentiation. Decellularization of in vitro cell-derived matrices can also enable the generation of autologous constructs from tissue specific cells or progenitor cells. Although decellularized bone tissue is widely used clinically in orthopaedic applications, the exciting potential of decellularized cartilage, skeletal muscle, tendon and ligament cell-derived matrices has only recently begun to be explored for ultimate translation to the orthopaedic clinic. PMID:24417915

EOS Reference Handbook 1999: A Guide to NASA's Earth Science Enterprise and the Earth Observing System

Science.gov (United States)

King, M. D. (Editor); Greenstone, R. (Editor)

2000-01-01

The content of this handbook includes Earth Science Enterprise; The Earth Observing System; EOS Data and Information System (EOSDIS); Data and Information Policy; Pathfinder Data Sets; Earth Science Information Partners and the Working Prototype-Federation; EOS Data Quality: Calibration and Validation; Education Programs; International Cooperation; Interagency Coordination; Mission Elements; EOS Instruments; EOS Interdisciplinary Science Investigations; and Points-of-Contact.

La salle de cinéma comme attraction spectacle : le cas Captain Eo à Disneyland Paris The Movie theater as attraction: The Case of Captain Eo at Disneyland Paris

Directory of Open Access Journals (Sweden)

Jean-Baptiste Massuet

2012-04-01

Full Text Available Cet article a pour ambition d’interroger le rapport du public à une salle de cinéma précise, au cœur du parc Disneyland Paris à Marne-La-Vallée. Cette salle projette à nouveau depuis juin 2010 l’attraction Captain Eo, film de science-fiction en 3D relief réalisé par Francis Ford Coppola en 1986, avec Michael Jackson dans le rôle-titre. Remplacé depuis 1998 par une autre attraction, Captain Eo fait son retour un an après le décès de la star, et implique dès lors un rapport très particulier à son public, par son statut d’hommage post-mortem. Il s’agira de comprendre la façon dont l’attraction structure son public, et la façon dont celui-ci peut construire à son tour le sens du film qu’il est en train de voir. C’est donc une approche sémio-pragmatique que nous convoquons ici, en nous référant à Roger Odin, afin d’envisager, à partir du film lui-même et de son mode de diffusion, ce que l’attraction Captain Eo révèle théoriquement du lien entre le spectateur et l’image d’une star comme Michael Jackson, qui plus est un an après son décès. Il s’agira de comprendre de quelle manière le film de Coppola ainsi que son contexte de diffusion – le parc d’attraction Disneyland Paris – permettent de penser ou d’interroger un type de pratique spectatorielle différent de celles engendrées par d'autres salles de cinéma.This article tries to question the link between the public and a precise movie theater, in Disneyland Paris Marne-La-Vallée, proposing again since june 2010 the attraction Captain Eo, science-fiction 3D movie by Francis Ford Coppola in 1986, starring Michael Jackson. Replaced since 1998 by another attraction, Captain Eo comes back one year after the death of the star, and implies un specific link with its public, being a post-mortem tribute. We have to understand the way the attraction builds its public, and the way this one can build the movie signification in return. We have

A review of virtual reality based training simulators for orthopaedic surgery

OpenAIRE

Vaughan, Neil; Dubey, Venketesh N.; Wainwright, Tom; Middleton, Robert

2015-01-01

This review presents current virtual reality based training simulators for hip, knee and other orthopaedic surgery, including elective and trauma surgical procedures. There have not been any reviews focussing on hip and knee orthopaedic simulators. A comparison of existing simulator features is provided to identify what is missing and what is required to improve upon current simulators. In total 11 total hip replacement pre-operative planning tools were analysed, plus 9 hip trauma fracture tr...

Mission operations concepts for Earth Observing System (EOS)

Science.gov (United States)

Kelly, Angelita C.; Taylor, Thomas D.; Hawkins, Frederick J.

1991-01-01

Mission operation concepts are described which are being used to evaluate and influence space and ground system designs and architectures with the goal of achieving successful, efficient, and cost-effective Earth Observing System (EOS) operations. Emphasis is given to the general characteristics and concepts developed for the EOS Space Measurement System, which uses a new series of polar-orbiting observatories. Data rates are given for various instruments. Some of the operations concepts which require a total system view are also examined, including command operations, data processing, data accountability, data archival, prelaunch testing and readiness, launch, performance monitoring and assessment, contingency operations, flight software maintenance, and security.

Aqua Moderate Resolution Imaging Spectroradiometer (MODIS) Chlorophyll (CHL) Global Mapped Data

Data.gov (United States)

National Aeronautics and Space Administration — MODIS (or Moderate Resolution Imaging Spectroradiometer) is a key instrument aboard the Terra (EOS AM) and Aqua (EOS PM) satellites. Terra's orbit around the Earth...

Reno Orthopaedic Trauma Fellowship business curriculum.

Science.gov (United States)

Althausen, Peter L; Bray, Timothy J; Hill, Austin D

2014-07-01

The Reno Orthopaedic Center (ROC) Trauma Fellowship business curriculum is designed to provide the fellow with a graduate level business practicum and research experience. The time commitments in a typical 12-month trauma fellowship are significant, rendering a traditional didactic master's in business administration difficult to complete during this short time. An organized, structured, practical business education can provide the trauma leaders of tomorrow with the knowledge and experience required to effectively navigate the convoluted and constantly changing healthcare system. The underlying principle throughout the curriculum is to provide the fellow with the practical knowledge to participate in cost-efficient improvements in healthcare delivery. Through the ROC Trauma Fellowship business curriculum, the fellow will learn that delivering healthcare in a manner that provides better outcomes for equal or lower costs is not only possible but a professional and ethical responsibility. However, instilling these values without providing actionable knowledge and programs would be insufficient and ineffective. For this reason, the core of the curriculum is based on individual teaching sessions with a wide array of hospital and private practice administrators. In addition, each section is equipped with a suggested reading list to maximize the learning experience. Upon completion of the curriculum, the fellow should be able to: (1) Participate in strategic planning at both the hospital and practice level based on analysis of financial and clinical data, (2) Understand the function of healthcare systems at both a macro and micro level, (3) Possess the knowledge and skills to be strong leaders and effective communicators in the business lexicon of healthcare, (4) Be a partner and innovator in the improvement of the delivery of orthopaedic services, (5) Combine scientific and strategic viewpoints to provide an evidence-based strategy for improving quality of care in a

XML DTD and Schemas for HDF-EOS

Science.gov (United States)

Ullman, Richard; Yang, Jingli

2008-01-01

An Extensible Markup Language (XML) document type definition (DTD) standard for the structure and contents of HDF-EOS files and their contents, and an equivalent standard in the form of schemas, have been developed.

Bridging EO Research, Operations and Collaborative Learning

Science.gov (United States)

Scarth, Peter

2016-04-01

Building flexible and responsive processing and delivery systems is key to getting EO information used by researchers, policy agents and the public. There are typically three distinct processes we tackle to get product uptake: undertake research, operationalise the validated research, and deliver information and garner feedback in an appropriate way. In many cases however, the gaps between these process elements are large and lead to poor outcomes. Good research may be "lost" and not adopted, there may be resistance to uptake by government or NGOs of significantly better operational products based on EO data, and lack of accessibility means that there is no use of interactive science outputs to improve cross disciplinary science or to start a dialog with citizens. So one of the the most important tasks, if we wish to have broad uptake of EO information and accelerate further research, is to link these processes together in a formal but flexible way. One of the ways to operationalize research output is by building a platform that can take research code and scale it across much larger areas. In remote sensing, this is typically a system that has access to current and historical corrected imagery with a processing pipeline built over the top. To reduce the demand on high level scientific programmers and allowing cross disciplinary researchers to hack and play and refine, this pipeline needs to be easy to use, collaborative and link to existing tools to encourage code experimentation and reuse. It is also critical to have efficient, tight integration with information delivery and extension components so that the science relevant to your user is available quickly and efficiently. The rapid expansion of open data licensing has helped this process, but building top-down web portals and tools without flexibility and regard for end user needs has limited the use of EO information in many areas. This research reports on the operalization of a scale independent time series

Research on the Influence of Orthopaedic Inserts on Pressure Distribution in the Foot

Directory of Open Access Journals (Sweden)

Ignas Rutulys

2011-02-01

Full Text Available The article examines the influence of individual orthopaedic inserts on pressure distribution in the foot. Feet deformations, types of orthopaedic inserts, materials and pressure in the foot testing methods are discussed. Experimental computer measurements of pressure in the foot before and after the use of inserts have been done. During research, the inserts made of different kinds of materials selected according to human weight, pathology, skin sensitivity and many other reasons has been used. It has been determinated that orthopaedic inserts have a more noticeable impact on children whose feet is adjusted easier if compared with those of adults.Article in Lithuanian

Strange particle measurements from the EOS TPC

International Nuclear Information System (INIS)

Justice, M.

1995-02-01

A high statistics sample of Λ's produced in 2 GeV/nucleon 5 8Ni + nat Cu collisions has been obtained with the EOS Time Projection Chamber at the Bevalac. The coverage of the EOS TPC is essentially 100% for y > y cm and extends down to P T = 0 where interesting effects such as collective radial expansion may be important. In addition, the detection of a majority of the charged particles in the TPC, along with the presence of directed flow for protons and heavier fragments at this beam energy, allows for the correlation of A production with respect to the event reaction plane. Our preliminary analysis indicates the first observation of a sidewards flow signature for A's. Comparisons with the cascade code ARC are made

Orthopaedic research in Australia: a bibliographic analysis of the publication rates in the top 15 journals.

Science.gov (United States)

Hohmann, Erik; Glatt, Vaida; Tetsworth, Kevin

2017-09-01

To investigate the publications rates and characteristics of the authors for manuscripts originating from Australia in the 15 highest ranked orthopaedic journals over a 5-year period. The 15 highest ranked journals in orthopaedics, based on their 2015 impact factor, were used to establish the total number of publications and cumulative impact factor points between January 2010 and December 2014. The affiliations of the primary author and co-authors were used to determine the involvement of Australian trained orthopaedic surgeons. Study location, research topic and anatomic areas were recorded. A total of 478 publications were identified; 110 of these manuscripts were principally authored by Australian trained orthopaedic surgeons or medical professionals affiliated with orthopaedics. In addition, 158 articles were published with orthopaedic surgery involvement where one of the co-authors was an Australian trained surgeon. Australian orthopaedic surgeon (FRACS) involvement was most commonly observed in the knee (n = 90; 33.6%) followed by the hip (n = 69; 25.7%) and basic sciences (n = 27; 10.1%). Surgeons in Sydney had the highest number of publications (n = 95; 35.4%), followed by Adelaide (n = 55; 20.5%) and Melbourne (n = 54; 20.1%). The results of this study demonstrate that the minority (23%) of the publications originating from Australia in the 15 highest-ranking orthopaedic journals were principally authored by either an Australian trained surgeon or a trainee surgeon. A total of 59% of the publications focused on the hip and knee. Sydney was the leading region, followed by Adelaide and Melbourne. These three regions published 76% of all manuscripts identified during the 5-year study period. © 2017 Royal Australasian College of Surgeons.

Canadian Vehicle Protection Program (EO considerations)

Science.gov (United States)

2012-10-09

Leopard 2 • Protection of the vehicle and their occupants was always considered on top of the priority list. • Currently, industry can provide...arge s 19 High Power Laser Characterization Laboratory 20 Conclusion • EO technologies are evolving extremely fast and cost/size/ weight is going down

Quality of online pediatric orthopaedic education materials.

Science.gov (United States)

Feghhi, Daniel P; Komlos, Daniel; Agarwal, Nitin; Sabharwal, Sanjeev

2014-12-03

Increased availability of medical information on the Internet empowers patients to look up answers to questions about their medical conditions. However, the quality of medical information available on the Internet is highly variable. Various tools for the assessment of online medical information have been developed and used to assess the quality and accuracy of medical web sites. In this study we used the LIDA tool (Minervation) to assess the quality of pediatric patient information on the AAOS (American Academy of Orthopaedic Surgeons) and POSNA (Pediatric Orthopaedic Society of North America) web sites. The accessibility, usability, and reliability of online medical information in the "Children" section of the AAOS web site and on the POSNA web site were assessed with use of the LIDA tool. Flesch-Kincaid (FK) and Flesch Reading Ease (FRE) values were also calculated to assess the readability of the pediatric education material. Patient education materials on each web site scored in the moderate range in assessments of accessibility, usability, and reliability. FK and FRE values indicated that the readability of each web site remained at a somewhat higher (more difficult) level than the recommended benchmark. The quality and readability of online information for children on the AAOS and POSNA web sites are acceptable but can be improved further. The quality of online pediatric orthopaedic patient education materials may affect communication with patients and their caregivers, and further investigation and modification of quality are needed. Copyright © 2014 by The Journal of Bone and Joint Surgery, Incorporated.

Thermodynamic model for predicting equilibrium conditions of clathrate hydrates of noble gases + light hydrocarbons: Combination of Van der Waals–Platteeuw model and sPC-SAFT EoS

International Nuclear Information System (INIS)

Abolala, Mostafa; Varaminian, Farshad

2015-01-01

Highlights: • Applying sPC-SAFT for phase equilibrium calculations. • Determining Kihara potential parameters for hydrate formers. • Successful usage of the model for systems with hydrate azeotropes. - Abstract: In this communication, equilibrium conditions of clathrate hydrates containing mixtures of noble gases (Argon, Krypton and Xenon) and light hydrocarbons (C 1 –C 3 ), which form structure I and II, are modeled. The thermodynamic model is based on the solid solution theory of Van der Waals–Platteeuw combined with the simplified Perturbed-Chain Statistical Association Fluid Theory equation of state (sPC-SAFT EoS). In dispersion term of sPC-SAFT EoS, the temperature dependent binary interaction parameters (k ij ) are adjusted; taking advantage of the well described (vapor + liquid) phase equilibria. Furthermore, the Kihara potential parameters are optimized based on the P–T data of pure hydrate former. Subsequently, these obtained parameters are used to predict the binary gas hydrate dissociation conditions. The equilibrium conditions of the binary gas hydrates predicted by this model agree well with experimental data (overall AAD P ∼ 2.17)

Does virtual reality simulation have a role in training trauma and orthopaedic surgeons?

Science.gov (United States)

Bartlett, J D; Lawrence, J E; Stewart, M E; Nakano, N; Khanduja, V

2018-05-01

Aims The aim of this study was to assess the current evidence relating to the benefits of virtual reality (VR) simulation in orthopaedic surgical training, and to identify areas of future research. Materials and Methods A literature search using the MEDLINE, Embase, and Google Scholar databases was performed. The results' titles, abstracts, and references were examined for relevance. Results A total of 31 articles published between 2004 and 2016 and relating to the objective validity and efficacy of specific virtual reality orthopaedic surgical simulators were identified. We found 18 studies demonstrating the construct validity of 16 different orthopaedic virtual reality simulators by comparing expert and novice performance. Eight studies have demonstrated skill acquisition on a simulator by showing improvements in performance with repeated use. A further five studies have demonstrated measurable improvements in operating theatre performance following a period of virtual reality simulator training. Conclusion The demonstration of 'real-world' benefits from the use of VR simulation in knee and shoulder arthroscopy is promising. However, evidence supporting its utility in other forms of orthopaedic surgery is lacking. Further studies of validity and utility should be combined with robust analyses of the cost efficiency of validated simulators to justify the financial investment required for their use in orthopaedic training. Cite this article: Bone Joint J 2018;100-B:559-65.

Breaking the EOS-gravity degeneracy with masses and pulsating frequencies of neutron stars

International Nuclear Information System (INIS)

Lin, Weikang; Li, Bao-An; Chen, Lie-Wen; Wen, De-Hua; Xu, Jun

2014-01-01

A thorough understanding of many astrophysical phenomena associated with compact objects requires reliable knowledge about both the equation of state (EOS) of super-dense nuclear matter and the theory of strong-field gravity simultaneously because of the EOS-gravity degeneracy. Currently, variations of the neutron star (NS) mass–radius correlation from using alternative gravity theories are much larger than those from changing the NS matter EOS within known constraints. At least two independent observables are required to break the EOS-gravity degeneracy. Using model EOSs for hybrid stars and a Yukawa-type non-Newtonian gravity, we investigate both the mass–radius correlation and pulsating frequencies of NSs. While the maximum mass of NSs increases, the frequencies of the f, p 1 , p 2 , and w I pulsating modes are found to decrease with the increasing strength of the Yukawa-type non-Newtonian gravity, providing a useful reference for future determination simultaneously of both the strong-field gravity and the supranuclear EOS by combining data of x-ray and gravitational wave emissions of NSs. (paper)

Intimate partner violence in orthopaedic trauma patients

NARCIS (Netherlands)

Sprague, S.A.

2013-01-01

Intimate partner violence (IPV) or domestic violence is a common and serious public health problem around the globe. Victims of IPV frequently present to health care practitioners including orthopaedic surgeons. Substantial research has been conducted on IPV over the past few decades, but very

Multi-Sensor Fusion of Infrared and Electro-Optic Signals for High Resolution Night Images

Directory of Open Access Journals (Sweden)

Victor Lawrence

2012-07-01

Full Text Available Electro-optic (EO image sensors exhibit the properties of high resolution and low noise level at daytime, but they do not work in dark environments. Infrared (IR image sensors exhibit poor resolution and cannot separate objects with similar temperature. Therefore, we propose a novel framework of IR image enhancement based on the information (e.g., edge from EO images, which improves the resolution of IR images and helps us distinguish objects at night. Our framework superimposing/blending the edges of the EO image onto the corresponding transformed IR image improves their resolution. In this framework, we adopt the theoretical point spread function (PSF proposed by Hardie et al. for the IR image, which has the modulation transfer function (MTF of a uniform detector array and the incoherent optical transfer function (OTF of diffraction-limited optics. In addition, we design an inverse filter for the proposed PSF and use it for the IR image transformation. The framework requires four main steps: (1 inverse filter-based IR image transformation; (2 EO image edge detection; (3 registration; and (4 blending/superimposing of the obtained image pair. Simulation results show both blended and superimposed IR images, and demonstrate that blended IR images have better quality over the superimposed images. Additionally, based on the same steps, simulation result shows a blended IR image of better quality when only the original IR image is available.

Analysis of scientific articles published in two general orthopaedic journals.

Science.gov (United States)

Holzer, Lukas A; Holzer, Gerold

2013-01-01

To give an overview of the behaviour and scientific contributions of the Journal of Bone and Joint Surgery American (JBJS-A) and British Volume (JBJS-B). 480 original articles published in 2009 were identified through a combined comprehensive computer and manual library search. Articles were assigned to 11 orthopaedic categories and by country, type and specialty of the institution. Possible grants and citations were analysed. USA led all countries in published articles (36,87%), followed by UK (20,62%) and South Korea (5,83%). Most studies published were performed at academic institutions (65,83 %), only 4,16% at private practices. Almost half of the articles (46,24%) were published in three categories: hip (19.16%), knee (13.75%) and trauma (13.33%). In both journals 47.15% articles had at least one funding source. A review of articles published in major journals allows to show how research in orthopaedics is distributed worldwide. This study shows that a variety of different journals is neccessary to reflect the broad spectrum of orthopaedics in depth. Level of Evidence III, Retrospective Comparative Study.

Polystyrene Foam EOS as a Function of Porosity and Fill Gas

Science.gov (United States)

Mulford, Roberta; Swift, Damian

2009-06-01

An accurate EOS for polystyrene foam is necessary for analysis of numerous experiments in shock compression, inertial confinement fusion, and astrophysics. Plastic to gas ratios vary between various samples of foam, according to the density and cell-size of the foam. A matrix of compositions has been investigated, allowing prediction of foam response as a function of the plastic-to-air ratio. The EOS code CHEETAH allows participation of the air in the decomposition reaction of the foam, Differences between air-filled, nitrogen-blown, and CO2-blown foams are investigated, to estimate the importance of allowing air to react with plastic products during decomposition. Results differ somewhat from the conventional EOS, which are generated from values for plastic extrapolated to low densities.

The orthopaedic management of myelomeningocele | Horn | South ...

African Journals Online (AJOL)

The orthopaedic management of myelomeningocele. A Horn, S Dix-Peek, S Mears, EB Hoffman. Abstract. Despite improvement in antenatal care and screening, myelomeningocele remains the most common congenital birth defect, with a reported incidence of 1 - 2.5/1000 patients in the Western Cape, South Africa.

Nigerian Journal of Orthopaedics and Trauma: Submissions

African Journals Online (AJOL)

The Nigerian Journal of Orthopaedics and Trauma is a peer reviewed journal publishing original research articles on all aspects of trauma, musculoskeletal ... initials and surnames of all authors, their highest academic degrees, affiliations / institutions and the name, address and e-mail address of the corresponding author.

The First World War and its influence on the development of orthopaedic surgery.

Science.gov (United States)

Scotland, T

2014-01-01

By December 1914, overwhelming numbers of soldiers with infected musculoskeletal wounds had filled hospitals in France and Britain. Frequently initial management had been inadequate. In 1915, patients with orthopaedic wounds were segregated for the first time when Robert Jones established an experimental orthopaedic unit in Alder Hey Hospital, Liverpool. In 1916 he opened the first of 17 orthopaedic centres in Britain to surgically treat and rehabilitate patients. Henry Gray from Aberdeen emerged as the leading authority in the management of acute musculoskeletal wounds in casualty clearing stations in France and Flanders. Gray had particular expertise in dealing with compound fractures of the femur for which he documented an 80% mortality rate in 1914-15.

The first observation of EO transitions from negative parity states in even-even nucleus 160Dy

International Nuclear Information System (INIS)

Grigoriev, E.P.

1988-01-01

In even-even deformed nuclei up to now EO-transitions were found only between the states of the same spin belonging to Κ π = O + rotational bands. There is no forbidenness for EO-transitions between states belonging to bands with any other quantum number Κ provided both initial and final states have the same J π Κ values. EO-transitions may depopulate odd-parity states. In odd nuclei β-vibrational states are identified by transition with EO-components. Here transitions also proceed between states with the same J π K numbers. Even-even nuclide 160 Dy is the first nucleus where the EO-transitions between odd-parity states have been found

Data links for the EOS TPC

International Nuclear Information System (INIS)

Bieser, F.; Jones, R.; McParland, C.

1991-01-01

This paper reports on the design and performance of high speed data links and slower configuration control links used between the EOS TPC detector and the data processing electronics. Data rates of 5 MBytes/link are maintained over 30m with optical isolation. Pedestal subtraction, hit detection, and data reordering are performed online

EO2HEAVEN: mitigating environmental health risks

CSIR Research Space (South Africa)

Le Rouw, Wouter J

2013-01-01

Full Text Available EO2HEAVEN has the primary objective to contribute to a better understanding of the complex relationships between environmental changes and their impact on human health. To achieve this, the project followed a multidisciplinary and user...

Vitamin D insufficiency in the elderly orthopaedic patient: an epidemic phenomenon.

Science.gov (United States)

Maier, Gerrit Steffen; Horas, Konstantin; Seeger, Jörn Bengt; Roth, Klaus Edgar; Kurth, Andreas Alois; Maus, Uwe

2015-04-01

The purpose of this observational study was to evaluate serum levels of 25-OH-D of elderly patients presenting with orthopaedic illness. Furthermore, we enquired about potential confounders and risk factors of hypovitaminosis D in comorbidities and daily medication of the elderly. Vitamin D levels in 1,083 patients aged >70 years and admitted to an orthopaedic surgery department were measured. Univariate and multivariate analyses were used to assess risk factors for insufficient vitamin D levels. Overall, 86 % of patients had insufficient serum levels of 25-OH-D and >60 % were vitamin D deficient. Serum vitamin D levels were lower during winter and months with fewer sunshine hours. Patients presenting with obesity, hypertension and osteoporosis were more likely to have low vitamin D levels. We found a high prevalence of hypovitaminosis D in elderly, nonhospitalized orthopaedic patients. Given the well-known effects of vitamin D on bone metabolism and muscle health, as well as its nonskeletal effects, vitamin D insufficiency may have a negative impact.

Level of Perception of Individualized Care and Satisfaction With Nursing in Orthopaedic Surgery Patients.

Science.gov (United States)

Tekin, Fatma; Findik, Ummu Yildiz

2015-01-01

Lately, individualized nursing care and patient satisfaction are important and current issues being discussed. But there is not enough information for patients undergoing orthopaedic surgery. The aim of this study was to determine the individualized care perception and satisfaction in nursing care levels in orthopaedic surgery patients. This descriptive cross-sectional study was conducted with 156 patients who underwent orthopaedic surgery. Data were collected using the personal information form, the Individualized Care Scale, and the Newcastle Satisfaction With Nursing Scale. The Spearman correlation analysis and descriptive statistics were performed. The mean individualized care and satisfaction with nursing care scores were found to be close to the preset maximum value, and it was determined that an increase in the level of awareness about nursing interventions and the level of perceived individualized care caused an increase in satisfaction levels regarding nursing care. Nurses should recognize the importance of performing individualized care in order to increase the level of satisfaction with nursing care in orthopaedic surgery patients.

Differentiation of eosinophilic leukemia EoL-1 cells into eosinophils induced by histone deacetylase inhibitors.

Science.gov (United States)

Ishihara, Kenji; Takahashi, Aki; Kaneko, Motoko; Sugeno, Hiroki; Hirasawa, Noriyasu; Hong, JangJa; Zee, OkPyo; Ohuchi, Kazuo

2007-03-06

EoL-1 cells differentiate into eosinophils in the presence of n-butyrate, but the mechanism has remained to be elucidated. Because n-butyrate can inhibit histone deacetylases, we hypothesized that the inhibition of histone deacetylases induces the differentiation of EoL-1 cells into eosinophils. In this study, using n-butyrate and two other histone deacetylase inhibitors, apicidin and trichostatin A, we have analyzed the relationship between the inhibition of histone deacetylases and the differentiation into eosinophils in EoL-1 cells. It was demonstrated that apicidin and n-butyrate induced a continuous acetylation of histones H4 and H3, inhibited the proliferation of EoL-1 cells without attenuating the level of FIP1L1-PDGFRA mRNA, and induced the expression of markers for mature eosinophils such as integrin beta7, CCR1, and CCR3 on EoL-1 cells, while trichostatin A evoked a transient acetylation of histones and induced no differentiation into eosinophils. These findings suggest that the continuous inhibition of histone deacetylases in EoL-1 cells induces the differentiation into mature eosinophils.

How does the knowledge environment shape procurement practices for orthopaedic medical devices in Mexico?

Science.gov (United States)

Lingg, Myriam; Wyss, Kaspar; Durán-Arenas, Luis

2016-07-08

In organisational theory there is an assumption that knowledge is used effectively in healthcare systems that perform well. Actors in healthcare systems focus on managing knowledge of clinical processes like, for example, clinical decision-making to improve patient care. We know little about connecting that knowledge to administrative processes like high-risk medical device procurement. We analysed knowledge-related factors that influence procurement and clinical procedures for orthopaedic medical devices in Mexico. We based our qualitative study on 48 semi-structured interviews with various stakeholders in Mexico: orthopaedic specialists, government officials, and social security system managers or administrators. We took a knowledge-management related perspective (i) to analyse factors of managing knowledge of clinical procedures, (ii) to assess the role of this knowledge and in relation to procurement of orthopaedic medical devices, and (iii) to determine how to improve the situation. The results of this study are primarily relevant for Mexico but may also give impulsion to other health systems with highly standardized procurement practices. We found that knowledge of clinical procedures in orthopaedics is generated inconsistently and not always efficiently managed. Its support for procuring orthopaedic medical devices is insufficient. Identified deficiencies: leaders who lack guidance and direction and thus use knowledge poorly; failure to share knowledge; insufficiently defined formal structures and processes for collecting information and making it available to actors of health system; lack of strategies to benefit from synergies created by information and knowledge exchange. Many factors are related directly or indirectly to technological aspects, which are insufficiently developed. The content of this manuscript is novel as it analyses knowledge-related factors that influence procurement of orthopaedic medical devices in Mexico. Based on our results we

Customizable orthopaedic oncology implants: one institution's experience with meeting current IRB and FDA requirements.

Science.gov (United States)

Willis, Alexander R; Ippolito, Joseph A; Patterson, Francis R; Benevenia, Joseph; Beebe, Kathleen S

2016-01-01

Customizable orthopaedic implants are often needed for patients with primary malignant bone tumors due to unique anatomy or complex mechanical problems. Currently, obtaining customizable orthopaedic implants for orthopaedic oncology patients can be an arduous task involving submitting approval requests to the Institutional Review Board (IRB) and the Food and Drug Administration (FDA). There is great potential for the delay of a patient's surgery and unnecessary paperwork if the submission pathways are misunderstood or a streamlined protocol is not in place. The objective of this study was to review the existing FDA custom implant approval pathways and to determine whether this process was improved with an institutional protocol. An institutional protocol for obtaining IRB and FDA approval for customizable orthopaedic implants was established with the IRB at our institution in 2013. This protocol was approved by the IRB, such that new patients only require submission of a modification to the existing protocol with individualized patient information. During the two-year period of 2013-2014, eight patients were retrospectively identified as having required customizable implants for various orthopaedic oncology surgeries. The dates of request for IRB approval, request for FDA approval, and total time to surgery were recorded, along with the specific pathway utilized for FDA approval. The average patient age was 12 years old (7-21 years old). The average time to IRB approval of a modification to the pre-approved protocol was 14 days (7-21 days). Average time to FDA approval after submission of the IRB approval to the manufacturer was 12.5 days (7-19 days). FDA approval was obtained for all implants as compassionate use requests in accordance with Section 561 of the Federal Food Drug and Cosmetic Act's expanded access provisions. Establishment of an institutional protocol with pre-approval by the IRB can expedite the otherwise time-consuming and complicated

Regenerative Medicine Will Make Orthopaedic Implants Obsolete In Our Time Orthopaedic Research Society First Annual Meeting Debate, San Diego, March 21st , 2017.

Science.gov (United States)

Johnstone, Brian; Jacobs, Joshua J; Sandell, Linda J; Wilkinson, J Mark

2018-05-10

The mission of the Orthopaedic Research Society is to promote and advance musculoskeletal research worldwide. With this in mind, the Annual Meeting Program Committee sought to establish a debate as a key component of the meeting. Our purpose was to provoke discussion on topics that are core to our mission and to engage all constituencies within the society by examining questions of broad relevance. To this end, the topic "Regenerative medicine will make orthopaedic implants obsolete in our time" was selected as the title of the inaugural debate. The arguments for and against the motion are presented in this perspectives article. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Predicting the post-operative length of stay for the orthopaedic trauma patient.

Science.gov (United States)

Chona, Deepak; Lakomkin, Nikita; Bulka, Catherine; Mousavi, Idine; Kothari, Parth; Dodd, Ashley C; Shen, Michelle S; Obremskey, William T; Sethi, Manish K

2017-05-01

Length of stay (LOS) is a major driver of cost and quality of care. A bundled payment system makes it essential for orthopaedic surgeons to understand factors that increase a patient's LOS. Yet, minimal data regarding predictors of LOS currently exist. Using the ACS-NSQIP database, this is the first study to identify risk factors for increased LOS for orthopaedic trauma patients and create a personalized LOS calculator. All orthopaedic trauma surgery between 2006 and 2013 were identified from the ACS-NSQIP database using CPT codes. Patient demographics, pre-operative comorbidities, anatomic location of injury, and post-operative in-hospital complications were collected. To control for individual patient comorbidities, a negative binomial regression model evaluated hospital LOS after surgery. Betas (β), were determined for each pre-operative patient characteristic. We selected significant predictors of LOS (p < 0.05) using backwards stepwise elimination. 49,778 orthopaedic trauma patients were included in the analysis. Deep incisional surgical site infections and superficial surgical site infections were associated with the greatest percent change in predicted LOS (β = 1.2760 and 1.2473, respectively; p < 0.0001 for both). A post-operative LOS risk calculator was developed based on the formula: [Formula: see text]. Utilizing a large prospective cohort of orthopaedic trauma patients, we created the first personalized LOS calculator based on pre-operative comorbidities, post-operative complications and location of surgery. Future work may assess the use of this calculator and attempt to validate its utility as an accurate model. To improve the quality measures of hospitals, orthopaedists must employ such predictive tools to optimize care and better manage resources.

Orthopaedic positioning in diagnostic radiology. 2. rev. and enlarged ed.

International Nuclear Information System (INIS)

Bernau, A.

1990-01-01

Effective roentgenology of the skeletal system very much relies on good knowledge of three main factors, namely patient positioning, film cassette positioning, and radiation field. The functional approach developed in orthopaedic diagnostics has been adopted for practical adjustment techniques in all X-ray examinations, so that e.g. examinations of the vertebral column and lower extremities now are carried out in upright position instead of the lying position, which of course corresponds to the real functional demand. In order to guarantee good reproducibility of X-ray images, a high standardization of positioning and adjustment techniques is to be achieved. The aspect of optimum radiological protection is also discussed, referring to shielding of the gonads, foils, measures for reduction of scattered radiation fields, and unambiguous labelling of film material. (orig./GDG) With 490 figs. and 1 separate folded tab [de

End-of-life (EoL) mobile phone management in Hong Kong households.

Science.gov (United States)

Deng, Wen-Jing; Giesy, John P; So, C S; Zheng, Hai-Long

2017-09-15

A questionnaire survey and interviews were conducted in households and end-of-life (EoL) mobile phone business centres in Hong Kong. Widespread Internet use, combined with the rapid evolution of modern social networks, has resulted in the more rapid obsolescence of mobile phones, and thus a tremendous increase in the number of obsolete phones. In 2013, the volume of EoL mobile phones generated in Hong Kong totalled at least 330 tonnes, and the amount is rising. Approximately 80% of electronic waste is exported to Africa and developing countries such as mainland China or Pakistan for recycling. However, the material flow of the large number of obsolete phones generated by the territory's households remains unclear. Hence, the flow of EoL mobile phones in those households was analysed, with the average lifespan of a mobile phone in Hong Kong found to be just under two years (nearly 23 months). Most EoL mobile phones are transferred to mainland China for disposal. Current recycling methods are neither environmentally friendly nor sustainable, with serious implications for the environment and human health. The results of this analysis provide useful information for planning the collection system and facilities needed in Hong Kong and mainland China to better manage EoL mobile phones in the future. Copyright © 2017 Elsevier Ltd. All rights reserved.

It Security and EO Systems

Science.gov (United States)

Burnett, M.

2010-12-01

One topic that is beginning to influence the systems that support these goals is that of Information Technology (IT) Security. Unsecure systems are vulnerable to increasing attacks and other negative consequences; sponsoring agencies are correspondingly responding with more refined policies and more stringent security requirements. These affect how EO systems can meet the goals of data and service interoperability and harmonization through open access, transformation and visualization services. Contemporary systems, including the vision of a system-of-systems (such as GEOSS, the Global Earth Observation System of Systems), utilize technologies that support a distributed, global, net-centric environment. These types of systems have a high reliance on the open systems, web services, shared infrastructure and data standards. The broader IT industry has developed and used these technologies in their business and mission critical systems for many years. Unfortunately, the IT industry, and their customers have learned the importance of protecting their assets and resources (computing and information) as they have been forced to respond to an ever increasing number and more complex illegitimate “attackers”. This presentation will offer an overview of work done by the CEOS WGISS organization in summarizing security threats, the challenges to responding to them and capturing the current state of the practice within the EO community.

Factors driving physician-hospital alignment in orthopaedic surgery.

Science.gov (United States)

Page, Alexandra E; Butler, Craig A; Bozic, Kevin J

2013-06-01

The relationships between physicians and hospitals are viewed as central to the proposition of delivering high-quality health care at a sustainable cost. Over the last two decades, major changes in the scope, breadth, and complexities of these relationships have emerged. Despite understanding the need for physician-hospital alignment, identification and understanding the incentives and drivers of alignment prove challenging. Our review identifies the primary drivers of physician alignment with hospitals from both the physician and hospital perspectives. Further, we assess the drivers more specific to motivating orthopaedic surgeons to align with hospitals. We performed a comprehensive literature review from 1992 to March 2012 to evaluate published studies and opinions on the issues surrounding physician-hospital alignment. Literature searches were performed in both MEDLINE(®) and Health Business™ Elite. Available literature identifies economic and regulatory shifts in health care and cultural factors as primary drivers of physician-hospital alignment. Specific to orthopaedics, factors driving alignment include the profitability of orthopaedic service lines, the expense of implants, and issues surrounding ambulatory surgery centers and other ancillary services. Evolving healthcare delivery and payment reforms promote increased collaboration between physicians and hospitals. While economic incentives and increasing regulatory demands provide the strongest drivers, cultural changes including physician leadership and changing expectations of work-life balance must be considered when pursuing successful alignment models. Physicians and hospitals view each other as critical to achieving lower-cost, higher-quality health care.

Find an Orthopaedic Foot and Ankle MD/DO

Science.gov (United States)

... All Site Content AOFAS / FootCareMD / Find a Surgeon Find a Foot & Ankle Orthopaedic Surgeon Page Content Who ... your prescribed treatment (surgical and/or non-surgical) ​ Find a Surgeon ​ Click here to find a foot ...

Cross-calibration of Medium Resolution Earth Observing Satellites by Using EO-1 Hyperion-derived Spectral Surface Reflectance from "Lunar Cal Sites"

Science.gov (United States)

Ungar, S.

2017-12-01

Over the past 3 years, the Earth Observing-one (EO-1) Hyperion imaging spectrometer was used to slowly scan the lunar surface at a rate which results in up to 32X oversampling to effectively increase the SNR. Several strategies, including comparison against the USGS RObotic Lunar Observatory (ROLO) mode,l are being employed to estimate the absolute and relative accuracy of the measurement set. There is an existing need to resolve discrepancies as high as 10% between ROLO and solar based calibration of current NASA EOS assets. Although the EO-1 mission was decommissioned at the end of March 2017, the development of a well-characterized exoatmospheric spectral radiometric database, for a range of lunar phase angles surrounding the fully illuminated moon, continues. Initial studies include a comprehensive analysis of the existing 17-year collection of more than 200 monthly lunar acquisitions. Specific lunar surface areas, such as a lunar mare, are being characterized as potential "lunar calibration sites" in terms of their radiometric stability in the presence of lunar nutation and libration. Site specific Hyperion-derived lunar spectral reflectance are being compared against spectrographic measurements made during the Apollo program. Techniques developed through this activity can be employed by future high-quality orbiting imaging spectrometers (such as HyspIRI and EnMap) to further refine calibration accuracies. These techniques will enable the consistent cross calibration of existing and future earth observing systems (spectral and multi-spectral) including those that do not have lunar viewing capability. When direct lunar viewing is not an option for an earth observing asset, orbiting imaging spectrometers can serve as transfer radiometers relating that asset's sensor response to lunar values through near contemporaneous observations of well characterized stable CEOS test sites. Analysis of this dataset will lead to the development of strategies to ensure more

The Experience and Effectiveness of Nurse Practitioners in Orthopaedic Settings: A Comprehensive Systematic Review.

Science.gov (United States)

Taylor, Anita; Staruchowicz, Lynda

This review asks "What is the experience and effectiveness of nurse practitioners in orthopaedic settings"?The objective of the quantitative component of this review is to synthesise the best available evidence on effectiveness of orthopaedic nurse practitioner specific care on patient outcomes and process indicators.The objective of the qualitative component of this review is to synthesise the best available evidence on the experience of becoming or being an orthopaedic nurse practitioner in relation to role development, role implementation and (ongoing) role evaluation.The objective of the text and opinion component of this review is to synthesise the best available evidence of the contemporary discourse on the effectiveness and experience of nurse practitioners in orthopaedic settings. Nurse practitioner roles have emerged in response to areas of unmet healthcare needs in a variety of settings. Nurse practitioners first evolved in the United States 40 years ago in response to a shortage of primary health care physicians. Nurse practitioners filled the void by providing access to primary health care services where otherwise there was none. Nurse practitioners comprise one branch of advanced nursing practice in the US along with Nurse Anaesthetists (NA), Clinical Nurse Specialists (CNS) and Nurse Midwives (NM). Canada soon followed America's lead by establishing the nurse practitioner role in 1967. Canada has two areas of advanced nursing practice, namely nurse practitioner and clinical nurse specialist; they are moving towards introducing nurse anaesthetists currently. The nurse practitioner role was introduced into the United Kingdom 20 years ago.There is commonality amongst the definition and characteristics of Nurse Practitioner (NP)/Advanced Practice Nurse (APN) role and practice internationally in terms of education, practice standards and regulation; operationally there is variability however. Australia's progress with nurse practitioners is very much

The older orthopaedic patient: general considerations.

Science.gov (United States)

Potter, Jane F

2004-08-01

People older than 65 years are more likely to need elective and emergent orthopaedic surgery compared with younger persons. They also experience significant benefits. Although age-related changes increase the risk of perioperative complications, understanding those changes allows prevention or at least early recognition and treatment when problems arise. Because of comorbidities, older persons take more medications that need to be managed in the perioperative period. Care could be simplified if patients were to bring their medications to the preoperative evaluation. Central nervous system sensitivity to certain pain medications (meperidine and propoxyphene) means that these drugs are best avoided as good alternatives exist (morphine and oxycodone). Adverse reactions to drugs are an important cause of acute confusion (delirium) that often complicates orthopaedic care. Early mobilization after surgery, avoiding certain drugs, avoiding restraints (including Foley catheters), attending to hydration, promoting normal sleep, compensating for sensory disorders, and stimulating daytime activities can prevent delirium. Patients with dementia are more likely to have delirium develop and, like many older people, will present special challenges in communication and decision making. Including family members in discussions may be helpful in ensuring truly informed consent.

Clinical features of anaerobic orthopaedic infections.

Science.gov (United States)

Lebowitz, Dan; Kressmann, Benjamin; Gjoni, Shpresa; Zenelaj, Besa; Grosgurin, Olivier; Marti, Christophe; Zingg, Matthieu; Uçkay, Ilker

2017-02-01

Some patient populations and types of orthopaedic surgery could be at particular risk for anaerobic infections. In this retrospective cohort study of operated adult patients with infections from 2004 to 2014, we assessed obligate anaerobes and considered first clinical infection episodes. Anaerobes, isolated from intra-operative samples, were identified in 2.4% of 2740 surgical procedures, of which half (33/65; 51%) were anaerobic monomicrobial infections. Propionibacterium acnes, a penicillin and vancomycin susceptible pathogen, was the predominantly isolated anaerobe. By multivariate analysis, the presence of fracture fixation plates was the variable most strongly associated with anaerobic infection (odds ratio: 2.1, 95% CI: 1.3-3.5). Anaerobes were also associated with spondylodesis and polymicrobial infections. In contrast, it revealed less likely in native bone or prosthetic joint infections and was not related to prior antibiotic use. In conclusion, obligate anaerobes in our case series of orthopaedic infections were rare, and mostly encountered in infections related to trauma with open-fracture fixation devices rather than clean surgical site infection. Anaerobes were often co-pathogens, and cultures most frequently recovered P. acnes. These observations thus do not support changes in current practices such as broader anaerobe coverage for perioperative prophylaxis.

Resources for your career in orthopaedic traumatology: what can the OTA do for you?

Science.gov (United States)

Mehta, Samir; Smith, Jeffrey M

2012-09-01

For those choosing a career in orthopaedic traumatology, several resources have been established by the Orthopaedic Trauma Association to facilitate progression from the years in training to the early years in practice. Young practitioners have access to educational programming, such as preparation for Part II of the Board Examination, web-based resources, such as on-line job postings, advocacy in health policy for the issues that will affect their ability to practice, and public relations efforts to increase their presence in the community. Ultimately, the resources set aside for the young practitioner by the Orthopaedic Trauma Association are intended to facilitate a sense of excellence, service, and community.

Data links for the EOS TPC

International Nuclear Information System (INIS)

Bieser, F.; Jones, R.; McParland, C.

1990-10-01

We report on the design and performance of high speed data links and slower configuration control links used between the EOS TPC detector and the data processing electronics. Data rates of 5MBytes/s/link are maintained over 30m with optical isolation. Pedestal subtraction, hit detection, and data reordering are performed online. 3 refs., 1 fig

Comparison of health literacy in privately insured and public hospital orthopaedic patients.

Science.gov (United States)

Cosic, Filip; Porter, Tabitha; Norsworthy, Cameron; Price, Rohan; Bedi, Harvinder

2018-05-14

Objective The aim of the present study was to quantify and compare patient health literacy between privately insured and public orthopaedic patients. Methods As part of the present cross-sectional study, elective postoperative orthopaedic patients across two sites were recruited and asked to complete a questionnaire at the first postoperative out-patient review. Patients were divided into three groups: (1) a public group (Public); (2) a private group (Private-pre); and (3) a private group that completed the questionnaire immediately after the out-patient review (Private-post). The questionnaire consisted of six questions regarding surgical management, expected recovery time and postoperative instructions. Patients were further asked to grade their satisfaction regarding information received throughout their management. Results In all, 150 patients completed the questionnaire, 50 in each of the three groups. Patients in the Public, Private-pre and Private-post groups answered a mean 2.74, 3.24 and 4.70 of 6 questions correctly respectively. The Private-pre group was 1.46-fold more likely to demonstrate correct health literacy than the Public group, whereas the Private-post group was 2.44-fold more likely to demonstrate improved health literacy than the Private-pre group. Patient satisfaction with information received was not associated with health literacy. Conclusion Limited health literacy in orthopaedic patients continues to be an area of concern. Both private and public orthopaedic patients demonstrated poor health literacy, but private patients demonstrated significant improvement after the out-patient review. What is known about the topic? Limited health literacy is a growing public health issue worldwide, with previous literature demonstrating a prevalence of low health literacy of 26% and marginal health literacy of 20% among all patient populations. Of concern, limited health literacy has been shown to result in a range of adverse health outcomes, including

Skeletal scintigraphy and SPECT/CT in orthopedic imaging; Knochenszintigrafie und SPECT/CT bei orthopaedischen Fragestellungen

Energy Technology Data Exchange (ETDEWEB)

Klaeser, B.; Walter, M.; Krause, T. [Inselspital Bern (Switzerland). Universitaetsklinik fuer Nuklearmedizin

2011-03-15

Multi-modality imaging with SPECT-CT in orthopaedics combines the excellent sensitivity of scintigraphy with the morphological information of CT as a key for specific interpretation of findings in bone scans. The result is an imaging modality with the clear potential to prove of value even in a competitive setting dominated by MRI, and to significantly add to diagnostic imaging in orthopaedics. SPECT-CT is of great value in the diagnostic evaluation after fractures, and - in contrast to MRI - it is well suited for imaging in patients with osteosyntheses and metallic implants. In sports medicine, SPECT-CT allows for a sensitive and specific detection of osseous stress reactions before morphological changes become detectable by CT or MRI. In patients with osseous pain syndromes, actively evolving degenerative changes as a cause of pain can be identified and accurately localized. Further, particularly prospective diagnostic studies providing comparative data are needed to strengthen the position of nuclear imaging in orthopaedics and sports medicine and to help implementing SPECT/CT in diagnostic algorithms. (orig.)

New design of care: Assessment of an interdisciplinary orthopaedic clinic with a pivot nurse in the province of Quebec.

Science.gov (United States)

Poder, Thomas G; Bellemare, Christian; Bédard, Suzanne K; He, Jie; Lemieux, Renald

2010-01-01

New designs of care in orthopaedic clinics are needed to cope with the shortage of orthopaedic surgeons and the lengthening of waiting times. To assess the effectiveness of an interdisciplinary orthopaedic clinic with a pivot nurse in the Canadian province of Quebec with regard to accessibility, quality of care, efficacy and efficiency of the clinic, and patient's quality of life. Two strategies were developed: (1) a selected cohort of new patients attending an orthopaedic service from February to September 2008 were entered into a database recording patient details, source of referral, diagnosis, satisfaction, and quality of life (36-Item Short Form Health Survey version 2). In this setting, 2 sets of questionnaires were administered to the patients: the first one during the first visit and the second one, 2 months later. A total of 243 patients from the case control were compared with 89 patients of the case study, where an interdisciplinary orthopaedic clinic with a pivot nurse has been developed; (2) costs per patient were calculated using the staff timesheets provided by the two orthopaedic clinics. The results showed a significant reduction in the waiting-list duration (accessibility) in the case study clinic owing to a strong decrease in the inappropriate consultations with the orthopaedic consultant. The quality of care remained high, and the target surgeries for total hip and knee replacement were reached, despite a strong shortage of orthopaedic doctors. Interdisciplinary orthopaedic clinic with a pivot nurse is a new approach in the province of Quebec and first results are encouraging.

What Provisions Do Orthopaedic Programs Make for Maternity, Paternity, and Adoption Leave?

Science.gov (United States)

Weiss, Jennifer; Teuscher, David

2016-09-01

The process of choosing medical specialty and residency programs is multifaceted. Today's generation of medical students may have an increased interest in work-life balance and time with their families. In considering this factor, medical students may be influenced by policy regarding maternity, paternity, and adoption leave during residency and fellowship training. Current policy among orthopaedic programs regarding maternity, paternity, and adoption leave is not well described. To understand the influence these policies may have on the choices that medical students make in choosing their specialty, the policies must first be better understood. (1) What proportion of orthopaedic programs have formal or unwritten policies regarding maternity, paternity, and adoptive leave? (2) What are the provisions for time away, allotment of time, and makeup options for trainees who take leave? (3) What proportion of orthopaedic programs report utilization of leave, and what proportions of leave are for maternity, paternity, or adoptive reasons? Accredited programs in orthopaedic surgery were identified through the Council of Orthopedic Residency Directors within the American Orthopaedic Association. Current program directors of these accredited programs were surveyed. The survey was emailed to 144 program directors, of which 141 emails were delivered. Responses were received from 45 program directors, representing 31% of programs. The survey focused on maternity, paternity, and adoptive leave, and it consisted of questions designed to explore program policies (formal, unwritten, no policy, or in development), time considerations (amount allowed, allocation of time away, and makeup requirements), and utilization (trainees who took leave and type of leave used). Most respondents have maternity leave policy (formal: 36 of 45 [80%]; unwritten: 17 of 45 [38%]). Sixteen programs (16 of 45 [36%]) reported having both a formal and an unwritten maternity leave policy. Less than half of

Vancouver winters: Environmental influences on inpatient adult orthopaedic trauma demographics

International Nuclear Information System (INIS)

Noordin, S.; Masri, B. A.

2014-01-01

Objective: To compare the pattern of adult inpatient orthopaedic injuries admitted at three Vancouver hospitals following one of the worst winter snowstorms in the region with the preceding control winter period. Methods: The surveillance study was conducted at the University of British Columbia, Vancouver, Canada, 2007 to 2010. Inpatient adult admissions for orthopaedic injuries at three hospitals were recorded, including age, gender, anatomic location of injury, type of fracture (open or closed), fixation method (internal versus external fixation), and length of acute care hospital stay. Comparisons between admissions during this weather pattern and admission during a previous winter with minimal snow were made. SPSS 19 was used for statistical analysis. Results: Of the 511 patients admitted under Orthopaedic trauma service during the significant winter snowstorms of December 2008 - January 2009, 100 (19.6%) (CI: 16.2%-23.2%) were due to ice and snow, whereas in the preceding mild winter only 18 of 415 (4.3%) (CI: 2.5%-6.8%) cases were related to snow (p<0.05). Ankle and wrist fractures were the most frequent injuries during the index snow storm period (p<0.05). At all the three institutions, 97 (96.5%) fractures were closed during the snowstorm as opposed to 17 (95%) during the control winter period. Internal fixation in 06 (89%) fractures as opposed to external fixation in 12 (11%) patients was the predominant mode of fixation across the board during both time periods. Conclusion: The study demonstrated a significantly higher inpatient orthopaedic trauma volume during the snowstorm more rigorous prospective studies need to be designed to gain further insight to solving these problems from a public health perspective. (author)

Competency-based education: a new model for teaching orthopaedics.

Science.gov (United States)

Alman, Benjamin A; Ferguson, Peter; Kraemer, William; Nousiainen, Markku T; Reznick, Richard K

2013-01-01

The current methods used to train residents to become orthopaedic surgeons are based on tradition, not evidence-based models. Educators have only a limited ability to assess trainees for competency using validated tests in various domains. The reduction in resident work hours limits the time available for clinical training, which has resulted in some calls for lengthening the training process. Another approach to address limited training hours is to focus training in a program that allows residents to graduate from a rotation based on demonstrated competency rather than on time on a service. A pilot orthopaedic residency curriculum, which uses a competency-based framework of resident training and maximizes the use of available training hours, has been designed and is being implemented.

P-Hacking in Orthopaedic Literature: A Twist to the Tail.

Science.gov (United States)

Bin Abd Razak, Hamid Rahmatullah; Ang, Jin-Guang Ernest; Attal, Hersh; Howe, Tet-Sen; Allen, John Carson

2016-10-19

"P-hacking" occurs when researchers preferentially select data or statistical analyses until nonsignificant results become significant. We wanted to evaluate if the phenomenon of p-hacking was evident in orthopaedic literature. We text-mined through all articles published in three top orthopaedic journals in 2015. For anonymity, we cipher-coded the three journals. We included all studies that reported a single p value to answer their main hypothesis. These p values were then charted and frequency graphs were generated to illustrate any evidence of p-hacking. Binomial tests were employed to look for evidence of evidential value and significance of p-hacking. Frequency plots for all three journals revealed evidence of p-hacking. Binomial tests for all three journals were significant for evidence of evidential value (p hacking was significant only for one journal (p = 0.0092). P-hacking is an evolving phenomenon that threatens to jeopardize the evidence-based practice of medicine. Although our results show that there is good evidential value for orthopaedic literature published in our top journals, there is some evidence of p-hacking of which authors and readers should be wary. Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated.

Spin states of asteroids in the Eos collisional family

Science.gov (United States)

Hanuš, J.; Delbo', M.; Alí-Lagoa, V.; Bolin, B.; Jedicke, R.; Ďurech, J.; Cibulková, H.; Pravec, P.; Kušnirák, P.; Behrend, R.; Marchis, F.; Antonini, P.; Arnold, L.; Audejean, M.; Bachschmidt, M.; Bernasconi, L.; Brunetto, L.; Casulli, S.; Dymock, R.; Esseiva, N.; Esteban, M.; Gerteis, O.; de Groot, H.; Gully, H.; Hamanowa, Hiroko; Hamanowa, Hiromi; Krafft, P.; Lehký, M.; Manzini, F.; Michelet, J.; Morelle, E.; Oey, J.; Pilcher, F.; Reignier, F.; Roy, R.; Salom, P. A.; Warner, B. D.

2018-01-01

Eos family was created during a catastrophic impact about 1.3 Gyr ago. Rotation states of individual family members contain information about the history of the whole population. We aim to increase the number of asteroid shape models and rotation states within the Eos collision family, as well as to revise previously published shape models from the literature. Such results can be used to constrain theoretical collisional and evolution models of the family, or to estimate other physical parameters by a thermophysical modeling of the thermal infrared data. We use all available disk-integrated optical data (i.e., classical dense-in-time photometry obtained from public databases and through a large collaboration network as well as sparse-in-time individual measurements from a few sky surveys) as input for the convex inversion method, and derive 3D shape models of asteroids together with their rotation periods and orientations of rotation axes. We present updated shape models for 15 asteroids and new shape model determinations for 16 asteroids. Together with the already published models from the publicly available DAMIT database, we compiled a sample of 56 Eos family members with known shape models that we used in our analysis of physical properties within the family. Rotation states of asteroids smaller than ∼ 20 km are heavily influenced by the YORP effect, whilst the large objects more or less retained their rotation state properties since the family creation. Moreover, we also present a shape model and bulk density of asteroid (423) Diotima, an interloper in the Eos family, based on the disk-resolved data obtained by the Near InfraRed Camera (Nirc2) mounted on the W.M. Keck II telescope.

Application of the PFV EoS correlation to excess molar volumes of (1-ethyl-3-methylimidazolium ethylsulfate + alkanols) at different temperatures

International Nuclear Information System (INIS)

Deenadayalu, N.; Sen, S.; Sibiya, P.N.

2009-01-01

The experimental densities for the binary systems of an ionic liquid and an alkanol {1-ethyl-3-methylimidazolium ethylsulfate [EMIM] + [EtSO 4 ] - + methanol or 1-propanol or 2-propanol} were determined at T = (298.15, 303.15, and 313.15) K. The excess molar volumes for the above systems were then calculated from the experimental density values for each temperature. The Redlich-Kister smoothing polynomial was used to fit the experimental results and the partial molar volumes were determined from the Redlich-Kister coefficients. For all the systems studied, the excess molar volume results were negative over the entire composition range for all the temperatures. The excess molar volumes were correlated with the pentic four parameter virial (PFV) equation of state (EoS) model

Method and apparatus for model construction within orthopaedic and traumatological operation planning

International Nuclear Information System (INIS)

Brix, F.; Hebbinghaus, D.

1985-01-01

Orthopaedic and traumatological surgeons are increasingly faced with surgical problems which require an unusual amount of planning. Endoprothetic measures concerning very small joints or posttraumatic conditions will illustrate the underlying idea. The same applies to constitutionally false positions which are to be corrected, or to plastic operations following, for instance, tumour resection. Planning means and methods available to date do not suffice for meeting these problematic situations as a rule. Thus, survey radiographs in two planes, tomograms, distance and spot-film radiograms will supply no picture true to scale and but an incomplete three-dimensional image. It is quite obvious that surgical strategy should be determined by means of a model true to scale, in a ''dress rehearsal'', so to speak. (orig./WU) [de

Orthopaedic Timing in Polytrauma in a Second Level Emergency Hospital. An Overrated Problem?

Science.gov (United States)

V, Dei Giudici; N, Giampaolini; A, Panfighi; M, Marinelli; R, Procaccini; A, Gigante

2015-01-01

The main concern for orthopaedic treatment in polytrauma has always been the same for almost forty years, which also regards “where” and “when” to proceed; correct surgical timing and correct interpretation of the DCO concept are still being debated. In the last few years, several attempts have been made to classify patients based on their clinical presentation and by trying to figure out which vital parameters are able to predict the patient’s outcome. This study evaluated all patients who presented with code red at the Emergency Department of our Hospital, a level II trauma center. For every patient, the following characteristics were noted: sex, age, day of hospitalization, orthopaedic trauma, time to surgery, presence of an associated surgical condition in the fields of general surgery, thoracic surgery, neurosurgery and vascular surgery, cardiac frequency, blood pressure, oxygen saturation, Glasgow Coma Scale and laboratory data. All patients included were divided into subgroups based on orthopaedic surgical timing. Two other subgroups were also identified and analyzed in detail: deceased and weekend traumas. A total of 208 patients were included. Our primary goal was to identify a correlation between the mortality and surgical timing of the orthopaedic procedures; our secondary goal was to recognize, if present, a statistically relevant association between historical, clinical and laboratory data, and mortality rate, defining any possible risk factor. A correlation between mortality and orthopaedic surgical timing was not found. Analyzing laboratory data revealed an interesting correlation between mortality and: blood pressure, platelet count, cardiac frequency, hematocrit, hemoglobin and age. PMID:26312113

Western Eos Chaos on Mars: A Potential Site for Future Landing and Returning Samples

Science.gov (United States)

Asif Iqbal Kakkassery; Rajesh, V. J.

2018-04-01

Introducing Eos Chaos as a potential area for collecting samples. Eos Chaos contains a number of aqueous minerals. We have detected zoisite — a least reported low-grade metamorphic mineral from this area.

Surgical advances during the First World War: the birth of modern orthopaedics.

Science.gov (United States)

Ramasamy, Arul; Eardley, W G P; Edwards, D S; Clasper, J C; Stewart, M P M

2016-02-01

The First World War (1914-1918) was the first truly industrial conflict in human history. Never before had rifle fire and artillery barrage been employed on a global scale. It was a conflict that over 4 years would leave over 750,000 British troops dead with a further 1.6 million injured, the majority with orthopaedic injuries. Against this backdrop, the skills of the orthopaedic surgeon were brought to the fore. Many of those techniques and systems form the foundation of modern orthopaedic trauma management. On the centenary of 'the War to end all Wars', we review the significant advances in wound management, fracture treatment, nerve injury and rehabilitation that were developed during that conflict. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Orthopaedic traumatology: fundamental principles and current controversies for the acute care surgeon.

Science.gov (United States)

Pharaon, Shad K; Schoch, Shawn; Marchand, Lucas; Mirza, Amer; Mayberry, John

2018-01-01

Multiply injured patients with fractures are co-managed by acute care surgeons and orthopaedic surgeons. In most centers, orthopaedic surgeons definitively manage fractures, but preliminary management, including washouts, splinting, reductions, and external fixations, may be performed by selected acute care surgeons. The acute care surgeon should have a working knowledge of orthopaedic terminology to communicate with colleagues effectively. They should have an understanding of the composition of bone, periosteum, and cartilage, and their reaction when there is an injury. Fractures are usually fixed urgently, but some multiply injured patients are better served with a damage control strategy. Extremity compartment syndrome should be suspected in all critically injured patients with or without fractures and a low threshold for compartment pressure measurements or empiric fasciotomy maintained. Acute care surgeons performing rib fracture fixation and other chest wall injury reconstructions should follow the principles of open fracture reduction and stabilization.

Orthopaedic traumatology: fundamental principles and current controversies for the acute care surgeon

Science.gov (United States)

Pharaon, Shad K; Schoch, Shawn; Marchand, Lucas; Mirza, Amer

2018-01-01

Multiply injured patients with fractures are co-managed by acute care surgeons and orthopaedic surgeons. In most centers, orthopaedic surgeons definitively manage fractures, but preliminary management, including washouts, splinting, reductions, and external fixations, may be performed by selected acute care surgeons. The acute care surgeon should have a working knowledge of orthopaedic terminology to communicate with colleagues effectively. They should have an understanding of the composition of bone, periosteum, and cartilage, and their reaction when there is an injury. Fractures are usually fixed urgently, but some multiply injured patients are better served with a damage control strategy. Extremity compartment syndrome should be suspected in all critically injured patients with or without fractures and a low threshold for compartment pressure measurements or empiric fasciotomy maintained. Acute care surgeons performing rib fracture fixation and other chest wall injury reconstructions should follow the principles of open fracture reduction and stabilization. PMID:29766123

Risk factors for surgical site infections following clean orthopaedic ...

African Journals Online (AJOL)

Risk factors for surgical site infections following clean orthopaedic operations. ... the host and environmental risk factors for surgical site infections following clean ... Materials and Methods: Consecutive patients who satisfied the inclusion ...

Infections in orthopaedic surgery : clinical and experimental studies

NARCIS (Netherlands)

Vogely, Henri Charles

2000-01-01

The diagnostic difficulties, variability in outcome and the heterogeinity of the problem of orthopaedic infections stimulated the author to a study of the literature, and several clinical and experimental studies. The diagnosis prosthesis-related infection can only be reached with an acceptable

EOS analysis of lower extremity segmental torsion in children and young adults.

Science.gov (United States)

Gaumétou, E; Quijano, S; Ilharreborde, B; Presedo, A; Thoreux, P; Mazda, K; Skalli, W

2014-02-01

Lower limb torsion varies substantially among healthy children during growth. Values reported in the literature to date have been obtained using semi-quantitative clinical or 2D measurement methods. Quantitative 3D measurement would help determine the physiological range of lower limb torsion. Low-dose stereoradiography with 3D reconstruction provides a good alternative. Its use increases in pediatrics because of radiation minimization. Previous studies have shown accurate and reproducible results of lower limbs reconstruction in adults and children but the torsional parameters haven't been measured yet. The present study reports the values of lower limb segmental torsion and its course during growth in a cohort of healthy children and young adults using the EOS low-dose biplanar X-ray. EOS 3D reconstruction is an accurate and reproducible method to measure the torsional parameters in children. Femoral torsion (FT) and tibial torsion (TT) were studied on 114 volunteers (228 lower limbs) from 6 to 30 years of age divided by age into 5 groups. The EOS™ acquisitions were obtained in subjects standing with their feet offset. Mean FT decreased during growth, passing from 21.6° to 18°, whereas mean TT increased from 26.8° to 34.7°. There was a statistically significant difference between the 2 extreme age groups, but no difference was found between any other age groups. The ICC for intra-observer reproducibility was 0.96 and 0.95 for FT and TT for the first operator, and 0.79 and 0.83 for the second operator respectively. The ICC for inter-observer reproducibility was 0.84 and 0.82 respectively. The course of lower limb segmental torsion observed was consistent with literature reports based upon clinical and 2D measurements. 3D reconstruction of EOS low-dose biplanar imaging appears to be a safe and reliable tool for lower limbs measurements, especially for investigating lower limb segmental torsion in children and adults. Level IV. Copyright © 2013. Published by

European Working Time Directive and the use of simulators and models in Irish orthopaedics.

LENUS (Irish Health Repository)

Egan, C

2011-09-07

OBJECTIVE: To report on the perceptions of a group of orthopaedic trainees and trainers on perceived effects of the proposed introduction of European Working Time Directive (EWTD) restrictions into Ireland and on the use of simulators in training orthopaedic skills. METHODS: A structured questionnaire was developed to evaluate the opinions of a group of orthopaedic surgeons and trainees at the annual national orthopaedic conference. RESULTS: There were 44 participants [12 consultants, 32 trainees (15 specialist registrars, 8 registrars, 9 senior house officers)]. Seventy-five percent of participants felt that both the quality of patient care and training would be negatively affected. A higher proportion of consultants than trainees felt that quality of life would be affected. A high proportion of participants (81.8%) had used a simulator or model to learn a surgical skill and 100% would consider using them again. CONCLUSIONS: While we wait for the full introduction of the EWTD hours the perception is that both quality of patient care and training will be affected. Models and simulators are well perceived as a method of training.

European Working Time Directive and the use of simulators and models in Irish orthopaedics.

Science.gov (United States)

Egan, C; Elliott, R; Fleming, P

2012-03-01

To report on the perceptions of a group of orthopaedic trainees and trainers on perceived effects of the proposed introduction of European Working Time Directive (EWTD) restrictions into Ireland and on the use of simulators in training orthopaedic skills. A structured questionnaire was developed to evaluate the opinions of a group of orthopaedic surgeons and trainees at the annual national orthopaedic conference. There were 44 participants [12 consultants, 32 trainees (15 specialist registrars, 8 registrars, 9 senior house officers)]. Seventy-five percent of participants felt that both the quality of patient care and training would be negatively affected. A higher proportion of consultants than trainees felt that quality of life would be affected. A high proportion of participants (81.8%) had used a simulator or model to learn a surgical skill and 100% would consider using them again. While we wait for the full introduction of the EWTD hours the perception is that both quality of patient care and training will be affected. Models and simulators are well perceived as a method of training.

Guidance, navigation, and control subsystem for the EOS-AM spacecraft

Science.gov (United States)

Linder, David M.; Tolek, Joseph T.; Lombardo, John

1992-01-01

This paper presents the preliminary design of the Guidance, Navigation, and Control (GN&C) subsystem for the EOS-AM spacecraft and specifically focuses on the GN&C Normal Mode design. First, a brief description of the EOS-AM science mission, instruments, and system-level spacecraft design is provided. Next, an overview of the GN&C subsystem functional and performance requirements, hardware, and operating modes is presented. Then, the GN&C Normal Mode attitude determination, attitude control, and navigation systems are detailed. Finally, descriptions of the spacecraft's overall jitter performance and Safe Mode are provided.

EO-Performance relationships in Reverse Internationalization by Chinese Global Startup OEMs: Social Networks and Strategic Flexibility

Science.gov (United States)

Chin, Tachia; Tsai, Sang-Bing; Fang, Kai; Zhu, Wenzhong; Yang, Dongjin; Liu, Ren-huai; Tsuei, Richard Ting Chang

2016-01-01

Due to the context-sensitive nature of entrepreneurial orientation (EO), it is imperative to in-depth explore the EO-performance mechanism in China at its critical, specific stage of economic reform. Under the context of “reverse internationalization” by Chinese global startup original equipment manufacturers (OEMs), this paper aims to manifest the unique links and complicated interrelationships between the individual EO dimensions and firm performance. Using structural equation modeling, we found that during reverse internationalization, proactiveness is positively related to performance; risk taking is not statistically associated with performance; innovativeness is negatively related to performance. The proactiveness-performance relationship is mediated by Strategic flexibility and moderated by social networking relationships. The dynamic and complex institutional setting, coupled with the issues of overcapacity and rising labor cost in China may explain why our distinctive results occur. This research advances the understanding of how contingent factors (social network relationships and strategic flexibility) facilitate entrepreneurial firms to break down institutional barriers and reap the most from EO. It brings new insights into how Chinese global startup OEMs draw on EO to undertake reverse internationalization, responding the calls for unraveling the heterogeneous characteristics of EO sub-dimensions and for more contextually-embedded treatment of EO-performance associations. PMID:27631368

EO-Performance relationships in Reverse Internationalization by Chinese Global Startup OEMs: Social Networks and Strategic Flexibility.

Science.gov (United States)

Chin, Tachia; Tsai, Sang-Bing; Fang, Kai; Zhu, Wenzhong; Yang, Dongjin; Liu, Ren-Huai; Tsuei, Richard Ting Chang

2016-01-01

Due to the context-sensitive nature of entrepreneurial orientation (EO), it is imperative to in-depth explore the EO-performance mechanism in China at its critical, specific stage of economic reform. Under the context of "reverse internationalization" by Chinese global startup original equipment manufacturers (OEMs), this paper aims to manifest the unique links and complicated interrelationships between the individual EO dimensions and firm performance. Using structural equation modeling, we found that during reverse internationalization, proactiveness is positively related to performance; risk taking is not statistically associated with performance; innovativeness is negatively related to performance. The proactiveness-performance relationship is mediated by Strategic flexibility and moderated by social networking relationships. The dynamic and complex institutional setting, coupled with the issues of overcapacity and rising labor cost in China may explain why our distinctive results occur. This research advances the understanding of how contingent factors (social network relationships and strategic flexibility) facilitate entrepreneurial firms to break down institutional barriers and reap the most from EO. It brings new insights into how Chinese global startup OEMs draw on EO to undertake reverse internationalization, responding the calls for unraveling the heterogeneous characteristics of EO sub-dimensions and for more contextually-embedded treatment of EO-performance associations.

The Earth Observing System (EOS) nickel-hydrogen battery

Science.gov (United States)

Bennett, Charles W.

1992-01-01

Information is given in viewgraph form on the Earth Observing System (EOS) nickel hydrogen battery. Information is given on the life evaluation test, cell characteristics, acceptance and characterization tests, and the battery system description.

Mechanical compatibility of sol-gel annealing with titanium for orthopaedic prostheses.

Science.gov (United States)

Greer, Andrew I M; Lim, Teoh S; Brydone, Alistair S; Gadegaard, Nikolaj

2016-01-01

Sol-gel processing is an attractive method for large-scale surface coating due to its facile and inexpensive preparation, even with the inclusion of precision nanotopographies. These are desirable traits for metal orthopaedic prostheses where ceramic coatings are known to be osteoinductive and the effects may be amplified through nanotexturing. However there are a few concerns associated with the application of sol-gel technology to orthopaedics. Primarily, the annealing stage required to transform the sol-gel into a ceramic may compromise the physical integrity of the underlying metal. Secondly, loose particles on medical implants can be carcinogenic and cause inflammation so the coating needs to be strongly bonded to the implant. These concerns are addressed in this paper. Titanium, the dominant material for orthopaedics at present, is examined before and after sol-gel processing for changes in hardness and flexural modulus. Wear resistance, bending and pull tests are also performed to evaluate the ceramic coating. The findings suggest that sol-gel coatings will be compatible with titanium implants for an optimum temperature of 500 °C.

Assessing heat fluxes and water quality trends in subalpine lakes from EO

Science.gov (United States)

Cazzaniga, Ilaria; Giardino, Claudia; Bresciani, Mariano; Elli, Chiara; Valerio, Giulia; Pilotti, Marco

2017-04-01

Lakes play a fundamental role in providing ecosystem services such as water supplying, hydrological regulation, climate change mitigation, touristic recreation (Schallenberg et al., 2013). Preserving and improving of quality of lakes waters, which is a function of either both natural and human influences, is therefore an important action to be considered. Remote Sensing techniques are spreading as useful instrument for lakes, by integrating classical in situ limnological measurements to frequent and synoptic monitoring capabilities. Within this study, Earth Observation data are exploited for understanding the temporal changes of water quality parameters over a decade, as well as for measuring the surface energy fluxes in recent years in deep clear lakes in the European subalpine ecoregion. According to Pareth et al. (2016), subalpine lakes are showing a clear response to climate change with an increase of 0.017 °C /year of lake surface temperature, whilst the human activities contribute to produce a large impact (agriculture, recreation, industry, fishing and drinking) on these lakes. The investigation is focused on Lake Iseo, which has shown a significant deterioration of water quality conditions since the seventies, and on Lake Garda, the largest Italian lake where EO data have been widely used for many purposes and applications (Giardino et al., 2014). Available ENVISAT-MERIS (2002-2012) and Landsat-8-OLI (2013-on going) imagery has been exploited to produce chlorophyll-a (chl-a) concentration maps, while Landsat-8-TIRS imagery has been used for estimating lake surface temperatures. MERIS images were processed through a neural network (namely the C2R processor, Doerffer et al., 2007), to correct the atmospheric effects and to retrieve water constituents concentration in optically complex deep waters. With regard to L8's images, some atmospheric correctors (e.g. ACOLITE and 6SV) were tested and validated to indentify, for each of the two lakes, the more accurate

Professional liability in orthopaedics and traumatology in Italy.

Science.gov (United States)

Tarantino, Umberto; Giai Via, Alessio; Macrì, Ernesto; Eramo, Alessandro; Marino, Valeria; Marsella, Luigi Tonino

2013-10-01

Interest in medical errors has increased during the last few years owing to the number of medical malpractice claims. Reasons for the increasing number of claims may be related to patients' higher expectations, iatrogenic injury, and the growth of the legal services industry. Claims analysis provides helpful information in specialties in which a higher number of errors occur, highlighting areas where orthopaedic care might be improved. We determined: (1) the number of claims involving orthopaedics and traumatology in Rome; (2) the risk of litigation in elective and trauma surgery; (3) the most common surgical procedures involved in claims and indemnity payments; (4) the time between the adverse medical event and the judgment date; and (5) issues related to informed consent. We analyzed 1925 malpractice judgments decided in the Civil Court of Rome between 2004 and 2010. In total, 243 orthopaedics claims were filed, and in 75% of these cases surgeons were found liable; 149 (61%) of these resulted from elective surgery. Surgical teams were sued in 30 claims and found liable in 22. The total indemnity payment ordered was more than €12,350,000 (USD 16,190,000). THA and spinal surgery were the most common surgical procedures involved. Inadequate informed consent was reported in 5.3% of cases. Our study shows that careful medical examination, accurate documentation in medical records, and adequate informed consent might reduce the number of claims. We suggest monitoring of court judgments would be useful to develop prevention strategies to reduce claims.

Aarhus Regenerative Orthopaedics Symposium (AROS)

DEFF Research Database (Denmark)

Foldager, Casper B.; Bendtsen, Michael; Berg, Lise C.

2016-01-01

to musculoskeletal pain and disability. The Aarhus Regenerative Orthopaedics Symposium (AROS) 2015 was motivated by the need to address regenerative challenges in an ageing population by engaging clinicians, basic scientists, and engineers. In this position paper, we review our contemporary understanding of societal......, patient-related, and basic science-related challenges in order to provide a reasoned roadmap for the future to deal with this compelling and urgent healthcare problem. © 2017 The Author(s). Published by Taylor & Francis on behalf of the Nordic Orthopedic Federation....

Behavioral Economics and Physician Board Meetings: Opportunity Cost, Regret, and Their Mitigation in Orthopaedic Surgery.

Science.gov (United States)

Sinicrope, Brent J; Roberts, Craig S; Sussman, Lyle

2018-01-01

Health care is a business. Health care providers must become familiar with terms such as opportunity costs, the potential loss or gain when one choice is made in lieu of another. The purpose of this study was to calculate the opportunity cost of two orthopaedic surgery society board meetings and discuss these in the context of behavioral economics and regret. A literature search was conducted to determine an orthopaedic surgeon's average yearly salary, hours worked per week, and weeks worked per year. The details of two orthopaedic surgery professional society meetings that one senior author (CSR) attended were used to calculate opportunity cost. Although the true benefits are multifactorial and difficult to objectively quantify, awareness of the cost-benefit ratio can help guide time and resource management to maximize the return on investment while minimizing buyer's remorse and perhaps influence the media by which medical meetings are held in the future. (Journal of Surgical Orthopaedic Advances 27(1):10-13, 2018).

Multichannel imager for littoral zone characterization

Science.gov (United States)

Podobna, Yuliya; Schoonmaker, Jon; Dirbas, Joe; Sofianos, James; Boucher, Cynthia; Gilbert, Gary

2010-04-01

This paper describes an approach to utilize a multi-channel, multi-spectral electro-optic (EO) system for littoral zone characterization. Advanced Coherent Technologies, LLC (ACT) presents their EO sensor systems for the surf zone environmental assessment and potential surf zone target detection. Specifically, an approach is presented to determine a Surf Zone Index (SZI) from the multi-spectral EO sensor system. SZI provides a single quantitative value of the surf zone conditions delivering an immediate understanding of the area and an assessment as to how well an airborne optical system might perform in a mine countermeasures (MCM) operation. Utilizing consecutive frames of SZI images, ACT is able to measure variability over time. A surf zone nomograph, which incorporates targets, sensor, and environmental data, including the SZI to determine the environmental impact on system performance, is reviewed in this work. ACT's electro-optical multi-channel, multi-spectral imaging system and test results are presented and discussed.

Compliance in Antibiotic Prophylaxis in Orthopaedics and Trauma ...

African Journals Online (AJOL)

Compliance in Antibiotic Prophylaxis in Orthopaedics and Trauma: Surgical Practice in a Tertiary Hospital, North-West Nigeria. ... or international guide lines, to reap the expected benefit of prophylactic antibiotics and avoid unwanted adverse effects like emergence of resistant bacteria strains and extra cost of healthcare.

Biodegradable magnesium alloys for orthopaedic applications: A review on corrosion, biocompatibility and surface modifications

Energy Technology Data Exchange (ETDEWEB)

Agarwal, Sankalp [Centre for Research in Engineering and Surface Technology, FOCAS Institute, Dublin Institute of Technology (Ireland); School of Food Science and Environmental Health, Cathal Brugha Street, Dublin Institute of Technology (Ireland); Curtin, James [School of Food Science and Environmental Health, Cathal Brugha Street, Dublin Institute of Technology (Ireland); Duffy, Brendan [Centre for Research in Engineering and Surface Technology, FOCAS Institute, Dublin Institute of Technology (Ireland); Jaiswal, Swarna, E-mail: swarna.jaiswal@dit.ie [Centre for Research in Engineering and Surface Technology, FOCAS Institute, Dublin Institute of Technology (Ireland)

2016-11-01

Magnesium (Mg) and its alloys have been extensively explored as potential biodegradable implant materials for orthopaedic applications (e.g. Fracture fixation). However, the rapid corrosion of Mg based alloys in physiological conditions has delayed their introduction for therapeutic applications to date. The present review focuses on corrosion, biocompatibility and surface modifications of biodegradable Mg alloys for orthopaedic applications. Initially, the corrosion behaviour of Mg alloys and the effect of alloying elements on corrosion and biocompatibility is discussed. Furthermore, the influence of polymeric deposit coatings, namely sol-gel, synthetic aliphatic polyesters and natural polymers on corrosion and biological performance of Mg and its alloy for orthopaedic applications are presented. It was found that inclusion of alloying elements such as Al, Mn, Ca, Zn and rare earth elements provides improved corrosion resistance to Mg alloys. It has been also observed that sol-gel and synthetic aliphatic polyesters based coatings exhibit improved corrosion resistance as compared to natural polymers, which has higher biocompatibility due to their biomimetic nature. It is concluded that, surface modification is a promising approach to improve the performance of Mg-based biomaterials for orthopaedic applications. - Highlights: • The Mg based alloys are promising candidates for orthopaedic applications. • The rapid corrosion of Mg can affect human cells, and causes infection and implant failure. • The various physiological factors and Mg alloying elements affect the corrosion and mechanical properties of implants. • The polymeric deposit coatings enhance the corrosion resistance and biocompatibility.

Supply and Demand Analysis of the Orthopaedic Trauma Surgeon Workforce in the United States.

Science.gov (United States)

Sielatycki, John A; Sawyer, Jeffrey R; Mir, Hassan R

2016-05-01

To investigate recent trends in the orthopaedic trauma workforce and to assess whether supply of orthopaedic trauma surgeons (OTS) matches the demand for their skills. Supply estimated using Orthopaedic Trauma Association (OTA) membership and American Academy of Orthopaedic Surgeons census data. The annual number of operative pelvic and acetabular fractures reported by American College of Surgeons verified trauma centers in the National Trauma Data Bank (NTDB) was used as a surrogate of demand. Because surrogates were used, the annual rate of change in OTA membership versus rate of change in operative injuries per NTDB center was compared. From 2002 to 2012, reported operative pelvic and acetabular injuries increased by an average of 21.0% per year. The number of reporting trauma centers increased by 27.2% per year. The number of OTA members increased each year except in 2009, with mean annual increase of 9.8%. The mean number of orthopaedic surgeons per NTDB center increased from 7.98 to 8.58, an average of 1.5% per year. The annual number of operative pelvic and acetabular fractures per NTDB center decreased from 27.1 in 2002 to 19.03 in 2012, down 2.0% per year. In the United States, from 2002 to 2012, the number of OTS trended upward, whereas operative pelvic and acetabular cases per reporting NTDB center declined. These trends suggest a net loss of such cases per OTS over this period.

Biodegradable magnesium alloys for orthopaedic applications: A review on corrosion, biocompatibility and surface modifications

International Nuclear Information System (INIS)

Agarwal, Sankalp; Curtin, James; Duffy, Brendan; Jaiswal, Swarna

2016-01-01

Magnesium (Mg) and its alloys have been extensively explored as potential biodegradable implant materials for orthopaedic applications (e.g. Fracture fixation). However, the rapid corrosion of Mg based alloys in physiological conditions has delayed their introduction for therapeutic applications to date. The present review focuses on corrosion, biocompatibility and surface modifications of biodegradable Mg alloys for orthopaedic applications. Initially, the corrosion behaviour of Mg alloys and the effect of alloying elements on corrosion and biocompatibility is discussed. Furthermore, the influence of polymeric deposit coatings, namely sol-gel, synthetic aliphatic polyesters and natural polymers on corrosion and biological performance of Mg and its alloy for orthopaedic applications are presented. It was found that inclusion of alloying elements such as Al, Mn, Ca, Zn and rare earth elements provides improved corrosion resistance to Mg alloys. It has been also observed that sol-gel and synthetic aliphatic polyesters based coatings exhibit improved corrosion resistance as compared to natural polymers, which has higher biocompatibility due to their biomimetic nature. It is concluded that, surface modification is a promising approach to improve the performance of Mg-based biomaterials for orthopaedic applications. - Highlights: • The Mg based alloys are promising candidates for orthopaedic applications. • The rapid corrosion of Mg can affect human cells, and causes infection and implant failure. • The various physiological factors and Mg alloying elements affect the corrosion and mechanical properties of implants. • The polymeric deposit coatings enhance the corrosion resistance and biocompatibility.

New RADIOM algorithm using inverse EOS

Science.gov (United States)

Busquet, Michel; Sokolov, Igor; Klapisch, Marcel

2012-10-01

The RADIOM model, [1-2], allows one to implement non-LTE atomic physics with a very low extra CPU cost. Although originally heuristic, RADIOM has been physically justified [3] and some accounting for auto-ionization has been included [2]. RADIOM defines an ionization temperature Tz derived from electronic density and actual electronic temperature Te. LTE databases are then queried for properties at Tz and NLTE values are derived from them. Some hydro-codes (like FAST at NRL, Ramis' MULTI, or the CRASH code at U.Mich) use inverse EOS starting from the total internal energy Etot and returning the temperature. In the NLTE case, inverse EOS requires to solve implicit relations between Te, Tz, and Etot. We shall describe these relations and an efficient solver successively implemented in some of our codes. [4pt] [1] M. Busquet, Radiation dependent ionization model for laser-created plasmas, Ph. Fluids B 5, 4191 (1993).[0pt] [2] M. Busquet, D. Colombant, M. Klapisch, D. Fyfe, J. Gardner. Improvements to the RADIOM non-LTE model, HEDP 5, 270 (2009).[0pt] [3] M.Busquet, Onset of pseudo-thermal equilibrium within configurations and super-configurations, JQSRT 99, 131 (2006)

EOS MLS Level 1B Data Processing, Version 2.2

Science.gov (United States)

Perun, Vincent; Jarnot, Robert; Pickett, Herbert; Cofield, Richard; Schwartz, Michael; Wagner, Paul

2009-01-01

A computer program performs level- 1B processing (the term 1B is explained below) of data from observations of the limb of the Earth by the Earth Observing System (EOS) Microwave Limb Sounder (MLS), which is an instrument aboard the Aura spacecraft. This software accepts, as input, the raw EOS MLS scientific and engineering data and the Aura spacecraft ephemeris and attitude data. Its output consists of calibrated instrument radiances and associated engineering and diagnostic data. [This software is one of several computer programs, denoted product generation executives (PGEs), for processing EOS MLS data. Starting from level 0 (representing the aforementioned raw data, the PGEs and their data products are denoted by alphanumeric labels (e.g., 1B and 2) that signify the successive stages of processing.] At the time of this reporting, this software is at version 2.2 and incorporates improvements over a prior version that make the code more robust, improve calibration, provide more diagnostic outputs, improve the interface with the Level 2 PGE, and effect a 15-percent reduction in file sizes by use of data compression.

Multilayer scaffolds in orthopaedic tissue engineering.

Science.gov (United States)

Atesok, Kivanc; Doral, M Nedim; Karlsson, Jon; Egol, Kenneth A; Jazrawi, Laith M; Coelho, Paulo G; Martinez, Amaury; Matsumoto, Tomoyuki; Owens, Brett D; Ochi, Mitsuo; Hurwitz, Shepard R; Atala, Anthony; Fu, Freddie H; Lu, Helen H; Rodeo, Scott A

2016-07-01

The purpose of this study was to summarize the recent developments in the field of tissue engineering as they relate to multilayer scaffold designs in musculoskeletal regeneration. Clinical and basic research studies that highlight the current knowledge and potential future applications of the multilayer scaffolds in orthopaedic tissue engineering were evaluated and the best evidence collected. Studies were divided into three main categories based on tissue types and interfaces for which multilayer scaffolds were used to regenerate: bone, osteochondral junction and tendon-to-bone interfaces. In vitro and in vivo studies indicate that the use of stratified scaffolds composed of multiple layers with distinct compositions for regeneration of distinct tissue types within the same scaffold and anatomic location is feasible. This emerging tissue engineering approach has potential applications in regeneration of bone defects, osteochondral lesions and tendon-to-bone interfaces with successful basic research findings that encourage clinical applications. Present data supporting the advantages of the use of multilayer scaffolds as an emerging strategy in musculoskeletal tissue engineering are promising, however, still limited. Positive impacts of the use of next generation scaffolds in orthopaedic tissue engineering can be expected in terms of decreasing the invasiveness of current grafting techniques used for reconstruction of bone and osteochondral defects, and tendon-to-bone interfaces in near future.

Promoting Strategic STEM Education Outreach Programming Using a Systems-Based STEM-EO Model

Science.gov (United States)

Ward, Annmarie R.

2015-01-01

In this paper a STEM Education Outreach (STEM-EO) Model for promoting strategic university outreach programming at Penn State University to the benefit of university, school district and community stakeholders is described. The model considers STEM-EO as a complex system involving overarching learning goals addressed within four outreach domains…

Medical opinions, beliefs and prescription of orthopaedic footwear: A survey of Dutch orthopaedists and rehabilitation practitioners.

NARCIS (Netherlands)

Boer, Hendrik; Seydel, E.R.

1998-01-01

Objectives: To get insight into medical opinions about the use of orthopaedic footwear and the medical and social factors related to the prescription of orthopaedic footwear by orthopaedists and rehabilitation practitioners. Methods: In this study 85 orthopaedists and 96 rehabilitation practitioners

Aqua Moderate Resolution Imaging Spectroradiometer (MODIS) Normalized Difference Vegetation Index Land Reflectance Global Binned Data

Data.gov (United States)

National Aeronautics and Space Administration — MODIS (or Moderate Resolution Imaging Spectroradiometer) is a key instrument aboard the Terra (EOS AM) and Aqua (EOS PM) satellites. Terra's orbit around the Earth...

EoW criteria for waste-derived aggregates

NARCIS (Netherlands)

Hjelmar, O.; Sloot, van der H.A.; Comans, R.N.J.; Wahlstrom, H.

2013-01-01

Waste-derived aggregates are being considered as possible candidates for development of End-of-Waste (EoW) criteria at European Union (EU) level in accordance with Article 6 (1) of the EU Waste Framework Directive (2008/98/EC) as a means of increasing the recovery of resources from waste. If a

Neoprene Orthopaedic Supports: An Underrecognised Cause of Allergic Contact Dermatitis

Directory of Open Access Journals (Sweden)

S. Hawkey

2015-01-01

Full Text Available Thioureas, often contained within neoprene to provide water resistance, are an important cause of allergic contact dermatitis (ACD in those who use neoprene products. We wish to present three cases of thiourea-induced ACD from three different orthopaedic supports containing neoprene. The first case was a 67-year-old woman who developed an itchy rash on her heel three weeks after using a neoprene insole for plantar fasciitis. The second case was a 47-year-old man who developed an itchy rash on his wrist after wearing neoprene wrist splints for psoriatic arthropathy. The third case was a 77-year-old woman who experienced a severe erythematous rash with blistering from a neoprene elbow brace she received following a humeral fracture. All patients were patch tested to the British Society of Cutaneous Allergy Standard and rubber series and a cut piece from all the relevant supports. At 96 hours, all patients had a + reaction to mixed dialkylthiourea, diethylthiourea, and the supports’ material. No other positive patch test reactions were identified. As neoprene is fast becoming one of the most popular materials used for orthopaedic supports, awareness of this reaction and close liaison between dermatologists and orthopaedic surgeons are therefore essential to allow for early recognition of this complication.

A new imaging 2D and 3D for musculo-skeletal physiology and pathology with low radiation dose and standing position: the EOS system; Une nouvelle imagerie osteo-articulaire basse dose en position debout: le systeme EOS

Energy Technology Data Exchange (ETDEWEB)

Dubousset, J. [Academie Nationale de Medecine, et Hopital Saint Vincent de Paul, Service de Chirurgie Orthopedique, 75 - Paris (France); Charpak, G.; Dorion, I. [Biospace, Instruments, 75 - Paris (France); Skalli, W.; Lavaste, F. [Ecole Nationale Superieure des Arts et Metiers, 75 - Paris (France); Deguise, J. [Laboratoire de Recherche en Imagerie Orthopedique, Montreal (Canada); Kalifa, G.; Ferey, S. [Hopital Saint Vincent de Paul, Service de Radiologie, 75 - Paris (France)

2005-06-01

Very precise combined work between multidisciplinary partners (radiation engineers in physics, engineers in bio-mechanics, medical radiologists and orthopedic pediatric surgeons) lead to the concept and development of a new low dose radiation device named EOS. This device allows 3 main advantages: (1) thanks to the invention of Georges Charpak (Nobel Price 1992) who designed gaseous detectors for X-rays, the reduction of dose necessary to obtain a good image of skeletal system was 8 to 10 times less for 2D imaging, compared to the dose necessary to obtain a 3D reconstruction from CT scan cuts the reduction factor was 800 to 1000. (2) The accuracy of 3D reconstruction obtained is as good as a 3D reconstruction from CT scan cuts. (3) The patient in addition get its imaging in standing functional position thank to the X-rays obtained from head to feet simultaneously AP and lateral. This is a big advantage compared to CT scan used only in lying position. From this simultaneous AP and lateral X-rays of the whole body thanks to the 3D bone external envelop technique, the engineers in bio-mechanics allowed to obtain 3D reconstruction of every level of osteo-articular system in standing position with an acceptable period of time (15 to 30 minutes). This (in spite of the evolution of standing MRI) allows more precise bone reconstruction in orthopedics especially at the level of spine, lower limbs, etc. In addition the fact to study the entire skeleton in standing functional position instead of small segmented studies given by CT scan in lying position produce a real improvement as well for physiology as for pathology of bone and joints disorders and especially for spinal pathology. (author)

Electro-Optical Imaging Fourier-Transform Spectrometer

Science.gov (United States)

Chao, Tien-Hsin; Zhou, Hanying

2006-01-01

An electro-optical (E-O) imaging Fourier-transform spectrometer (IFTS), now under development, is a prototype of improved imaging spectrometers to be used for hyperspectral imaging, especially in the infrared spectral region. Unlike both imaging and non-imaging traditional Fourier-transform spectrometers, the E-O IFTS does not contain any moving parts. Elimination of the moving parts and the associated actuator mechanisms and supporting structures would increase reliability while enabling reductions in size and mass, relative to traditional Fourier-transform spectrometers that offer equivalent capabilities. Elimination of moving parts would also eliminate the vibrations caused by the motions of those parts. Figure 1 schematically depicts a traditional Fourier-transform spectrometer, wherein a critical time delay is varied by translating one the mirrors of a Michelson interferometer. The time-dependent optical output is a periodic representation of the input spectrum. Data characterizing the input spectrum are generated through fast-Fourier-transform (FFT) post-processing of the output in conjunction with the varying time delay.

A Reference Implementation of the OGC CSW EO Standard for the ESA HMA-T project

Science.gov (United States)

Bigagli, Lorenzo; Boldrini, Enrico; Papeschi, Fabrizio; Vitale, Fabrizio

2010-05-01

This work was developed in the context of the ESA Heterogeneous Missions Accessibility (HMA) project, whose main objective is to involve the stakeholders, namely National space agencies, satellite or mission owners and operators, in an harmonization and standardization process of their ground segment services and related interfaces. Among HMA objectives was the specification, conformance testing, and experimentation of two Extension Packages (EPs) of the ebRIM Application Profile (AP) of the OGC Catalog Service for the Web (CSW) specification: the Earth Observation Products (EO) EP (OGC 06-131) and the Cataloguing of ISO Metadata (CIM) EP (OGC 07-038). Our contributions have included the development and deployment of Reference Implementations (RIs) for both the above specifications, and their integration with the ESA Service Support Environment (SSE). The RIs are based on the GI-cat framework, an implementation of a distributed catalog service, able to query disparate Earth and Space Science data sources (e.g. OGC Web Services, Unidata THREDDS) and to expose several standard interfaces for data discovery (e.g. OGC CSW ISO AP). Following our initial planning, the GI-cat framework has been extended in order to expose the CSW.ebRIM-CIM and CSW.ebRIM-EO interfaces, and to distribute queries to CSW.ebRIM-CIM and CSW.ebRIM-EO data sources. We expected that a mapping strategy would suffice for accommodating CIM, but this proved to be unpractical during implementation. Hence, a model extension strategy was eventually implemented for both the CIM and EO EPs, and the GI-cat federal model was enhanced in order to support the underlying ebRIM AP. This work has provided us with new insights into the different data models for geospatial data, and the technologies for their implementation. The extension is used by suitable CIM and EO profilers (front-end mediator components) and accessors (back-end mediator components), that relate ISO 19115 concepts to EO and CIM ones. Moreover

Biodegradable magnesium alloys for orthopaedic applications: A review on corrosion, biocompatibility and surface modifications.

Science.gov (United States)

Agarwal, Sankalp; Curtin, James; Duffy, Brendan; Jaiswal, Swarna

2016-11-01

Magnesium (Mg) and its alloys have been extensively explored as potential biodegradable implant materials for orthopaedic applications (e.g. Fracture fixation). However, the rapid corrosion of Mg based alloys in physiological conditions has delayed their introduction for therapeutic applications to date. The present review focuses on corrosion, biocompatibility and surface modifications of biodegradable Mg alloys for orthopaedic applications. Initially, the corrosion behaviour of Mg alloys and the effect of alloying elements on corrosion and biocompatibility is discussed. Furthermore, the influence of polymeric deposit coatings, namely sol-gel, synthetic aliphatic polyesters and natural polymers on corrosion and biological performance of Mg and its alloy for orthopaedic applications are presented. It was found that inclusion of alloying elements such as Al, Mn, Ca, Zn and rare earth elements provides improved corrosion resistance to Mg alloys. It has been also observed that sol-gel and synthetic aliphatic polyesters based coatings exhibit improved corrosion resistance as compared to natural polymers, which has higher biocompatibility due to their biomimetic nature. It is concluded that, surface modification is a promising approach to improve the performance of Mg-based biomaterials for orthopaedic applications. Copyright © 2016 Elsevier B.V. All rights reserved.

Orthopaedic Implants And Prosthesis: Economic Costs Of Post ...

African Journals Online (AJOL)

OBJECTIVE: To assess the economic impact of post-operative wound infection in trauma patients who had open reduction and internal fixation with implants and prostheses following fractures of the femur. METHOD: This is a 2-year case controlled prospective study carried out at the National Orthopaedic Hospital, Lagos.

Mechanism for the differentiation of EoL-1 cells into eosinophils by histone deacetylase inhibitors.

Science.gov (United States)

Kaneko, Motoko; Ishihara, Kenji; Takahashi, Aki; Hong, Jangja; Hirasawa, Noriyasu; Zee, Okpyo; Ohuchi, Kazuo

2007-01-01

EoL-1 cells have a FIP1L1-PDGFRA fusion gene which causes the transformation of eosinophilic precursor cells into leukemia cells. Recently, we suggested that the induction of differentiation of EoL-1 cells into eosinophils by the HDAC inhibitors apicidin and n-butyrate is due to the continuous inhibition of HDACs. However, neither apicidin nor n-butyrate inhibited the expression of FIP1L1-PDGFRA mRNA, although both these inhibitors suppressed cell proliferation. Therefore, in this study, we analyzed whether the levels of FIP1L1-PDGFRalpha protein and phosphorylated-Stat5 involved in the signaling for the proliferation of EoL-1 cells are attenuated by HDAC inhibitors. EoL-1 cells were incubated in the presence of apicidin, TSA or n-butyrate. FIP1L1-PDGFRalpha and phosphorylated-Stat5 were detected by Western blotting. Treatment of EoL-1 cells with apicidin at 100 nM or n-butyrate at 500 microM decreased the levels of FIP1L1-PDGFRalpha protein and phosphorylated-Stat5, while that with trichostatin A at 30 nM did not. The decrease in the level of FIP1L1-PDGFRalpha protein caused by apicidin and n-butyrate might be one of the mechanisms by which EoL-1 cells are induced to differentiate into eosinophils by these HDAC inhibitors.

EOS MLS Lessons Learned: Design Ideas for Safer and Lower Cost Operations

Science.gov (United States)

Miller, Dominick

2012-01-01

The Earth Observing System (EOS) Microwave Limb Sounder (MLS) is a complex instrument with a front end computer and 32 subsystem computers. MLS is one of four instruments on NASA's EOS Aura spacecraft With almost 8 years in orbit, MLS has a few lessons learned which can be applied during the design phase of future instruments to effect better longevity, more robust operations and a significant cost benefit during operations phase.

Multicenter collaborative for orthopaedic research in India: An opportunity for global leadership

Directory of Open Access Journals (Sweden)

Mathew George

2008-01-01

Full Text Available Road traffic accidents are increasing at an alarming rate and have become a major public health concern in India. In addition, there is a lack of trauma research output and reliable data from India. There are several issues and challenges that have presented an opportunity for researchers and surgeons in India to develop a collaborative aimed at improving the quality and productivity of orthopaedic trauma research. Establishing a network of surgical researchers across India is a necessary first step towards global leadership in orthopaedic surgery trials.

Authorship trends in the Journal of Orthopaedic Research: A bibliometric analysis.

Science.gov (United States)

Seetharam, Abhijit; Ali, Mohammed T; Wang, Christine Y; Schultz, Katherine E; Fischer, James P; Lunsford, Shatoria; Whipple, Elizabeth C; Loder, Randall T; Kacena, Melissa A

2018-05-18

Publications are an important tool to measure one's success and achievement in academia. They can help propel a career forward and move one into a position of leadership. The overall purpose of this study was to investigate changes in bibliometric variables, authorship, and collaboration trends in the Journal of Orthopaedic Research (JOR®), since its inception in 1983. A bibliometric analysis was completed for all manuscripts meeting the inclusion criteria (638), which were published throughout the inaugural year plus one representative year of each decade. Several parameters were investigated including numbers of manuscripts, authors, collaborating institutions/countries, references, pages, and citations; region of origin and gender of authors over time and by region were main focuses. Significant increases over time were observed in all bibliometric variables analyzed except in the number of pages and citations. There was an approximate 27% point increase for both female first and corresponding authors from 1983 to 2015. While this is most likely due to the increase in the number of women that have entered the field over time, similar increases in the percentage of women holding positions on the JOR editorial board or in leadership positions within in the field may have also contributed to improvements in gender parity. Understanding changes in publishing characteristics over time, by region, and by gender are critical, especially with the rising demands of publishing in academia. JOR has seen increase in most variables analyzed, including improvements in authorship by women in the field of orthopaedic research. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

Postinjury anxiety and social support among collegiate athletes: a comparison between orthopaedic injuries and concussions.

Science.gov (United States)

Covassin, Tracey; Crutcher, Bryan; Bleecker, Alisha; Heiden, Erin O; Dailey, Alexander; Yang, Jingzhen

2014-01-01

When an athlete is injured, the primary focus of the sports medicine team is to treat the physical effects of the injury. However, many injured athletes experience negative psychological responses, including anxiety, regarding their injury. To compare the anxiety and social support of athletes with concussions and a matched group of athletes with orthopaedic injuries. Cross-sectional study. Athletic training room. A total of 525 injuries among athletes from 2 Big Ten universities were observed. Of these, 63 concussion injuries were matched with 63 orthopaedic injuries for the athlete's sex, sport, and time loss due to injury. Clinical measures included the State-Trait Anxiety Inventory (which measures both state and trait anxiety) and the modified 6-item Social Support Questionnaire. The group with concussions relied on their family for social support 89% of the time, followed by friends (78%), teammates (65%), athletic trainers (48%), coaches (47%), and physicians (35%). The group with orthopaedic injuries relied on their family for social support 87% of the time, followed by friends (84%), teammates (65%), athletic trainers (57%), coaches (51%), and physicians (36%). We found no differences for the State-Trait Anxiety Inventory (t = -1.38, P = .193) between the concussed and orthopaedic-injury groups. Social Support Questionnaire scores were significant predictors for postinjury state anxiety. Specifically, increased scores were associated with decreased postinjury state anxiety (β = -4.21, P = .0001). Both the concussed athletes and those with orthopaedic injuries experienced similar state and trait anxiety and relied on similar sources of social support postinjury. However, athletes with orthopaedic injuries reported greater satisfaction with support from all sources compared with concussed athletes. In contrast, concussed athletes showed more significant predictor models of social support on state anxiety at return to play.

Understanding (Galactic) Foreground Emission: A Road To Success For The LOFAR-EoR Experiment

NARCIS (Netherlands)

Jelic, Vibor; Lofar Eor Team, [Unknown

The LOFAR-EoR experiment will use the innovative technology and capabilities of the radio telescope LOFAR to study the Epoch of Reionization (EoR). However, feeble cosmological radiation is swamped by the prominent foreground emission of our Galaxy and other extragalactic radio sources. This

Aqua Moderate Resolution Imaging Spectroradiometer (MODIS) Diffuse Attenuation Coefficient for Downwelling Irradiance (KD) Global Mapped Data

Data.gov (United States)

National Aeronautics and Space Administration — MODIS (or Moderate Resolution Imaging Spectroradiometer) is a key instrument aboard the Terra (EOS AM) and Aqua (EOS PM) satellites. Terra's orbit around the Earth...

Terra Moderate Resolution Imaging Spectroradiometer (MODIS) Photosynthetically Available Radiation (PAR) Global Binned Data, reprocesing v2018

Data.gov (United States)

National Aeronautics and Space Administration — MODIS (or Moderate Resolution Imaging Spectroradiometer) is a key instrument aboard the Terra (EOS AM) and Aqua (EOS PM) satellites. Terra's orbit around the Earth...

Orthopaedic injuries in children: Federal Medical Centre, Umuahia ...

African Journals Online (AJOL)

Background: Worldwide, trauma is a recognized leading cause of childhood morbidity, mortality and disability. Aim: To review the causes and consequences of orthopaedic injuries in children. Methods: A retrospective study of all injuries in children 14 years and below seen at the Federal Medical Centre Umuahia from 1st ...

Local corticosteroid injections: Rational use in common orthopaedic ...

African Journals Online (AJOL)

The use of local corticosteroid injections in orthopaedic practice is common due to their anti- inflammatory and analgesic effect. However, the use may result in local or systemic complications. Moreover, the conflicting reports on their benefits versus side effects, throws the average user in confusion or fear. This review ...

[The Development and Application of the Orthopaedics Implants Failure Database Software Based on WEB].

Science.gov (United States)

Huang, Jiahua; Zhou, Hai; Zhang, Binbin; Ding, Biao

2015-09-01

This article develops a new failure database software for orthopaedics implants based on WEB. The software is based on B/S mode, ASP dynamic web technology is used as its main development language to achieve data interactivity, Microsoft Access is used to create a database, these mature technologies make the software extend function or upgrade easily. In this article, the design and development idea of the software, the software working process and functions as well as relative technical features are presented. With this software, we can store many different types of the fault events of orthopaedics implants, the failure data can be statistically analyzed, and in the macroscopic view, it can be used to evaluate the reliability of orthopaedics implants and operations, it also can ultimately guide the doctors to improve the clinical treatment level.

Template-Independent Enzymatic Oligonucleotide Synthesis (TiEOS): Its History, Prospects, and Challenges.

Science.gov (United States)

Jensen, Michael A; Davis, Ronald W

2018-03-27

There is a growing demand for sustainable methods in research and development, where instead of hazardous chemicals, an aqueous medium is chosen to perform biological reactions. In this Perspective, we examine the history and current methodology of using enzymes to generate artificial single-stranded DNA. By using traditional solid-phase phosphoramidite chemistry as a metric, we also explore criteria for the method of template-independent enzymatic oligonucleotide synthesis (TiEOS). As its key component, we delve into the biology of one of the most enigmatic enzymes, terminal deoxynucleotidyl transferase (TdT). As TdT is found to exponentially increase antigen receptor diversity in the vertebrate immune system by adding nucleotides in a template-free manner, researchers have exploited this function as an alternative to the phosphoramidite synthesis method. Though TdT is currently the preferred enzyme for TiEOS, its random nucleotide incorporation presents a barrier in synthesis automation. Taking a closer look at the TiEOS cycle, particularly the coupling step, we find it is comprised of additions > n+1 and deletions. By tapping into the physical and biochemical properties of TdT, we strive to further elucidate its mercurial behavior and offer ways to better optimize TiEOS for production-grade oligonucleotide synthesis.

78 FR 21129 - Orthopaedic and Rehabilitation Devices Panel of the Medical Devices Advisory Committee; Notice of...

Science.gov (United States)

2013-04-09

... radiofrequency band ranging between 13 megahertz to 27.12 megahertz and is intended for the treatment of medical...] Orthopaedic and Rehabilitation Devices Panel of the Medical Devices Advisory Committee; Notice of Meeting... the public. Name of Committee: Orthopaedic and Rehabilitation Devices Panel of the Medical Devices...

Integrating Chlorophyll fapar and Nadir Photochemical Reflectance Index from EO-1/Hyperion to Predict Cornfield Daily Gross Primary Production

Science.gov (United States)

Zhang, Qingyuan; Middleton, Elizabeth M.; Cheng, Yen-Ben; Huemmrich, K. Fred; Cook, Bruce D.; Corp, Lawrence A.; Kustas, William P.; Russ, Andrew L.; Prueger, John H.; Yao, Tian

2016-01-01

The concept of light use efficiency (Epsilon) and the concept of fraction of photosynthetically active ration (PAR) absorbed for vegetation photosynthesis (PSN), i.e., fAPAR (sub PSN), have been widely utilized to estimate vegetation gross primary productivity (GPP). It has been demonstrated that the photochemical reflectance index (PRI) is empirically related to e. An experimental US Department of Agriculture (USDA) cornfield in Maryland was selected as our study field. We explored the potential of integrating fAPAR(sub chl) (defined as the fraction of PAR absorbed by chlorophyll) and nadir PRI (PRI(sub nadir)) to predict cornfield daily GPP. We acquired nadir or near-nadir EO-1/Hyperion satellite images that covered the cornfield and took nadir in-situ field spectral measurements. Those data were used to derive the PRI(sub nadir) and fAPAR (sub chl). The fAPAR (sub chl) is retrieved with the advanced radiative transfer model PROSAIL2 and the Metropolis approach, a type of Markov Chain Monte Carlo (MCMC) estimation procedure. We define chlorophyll light use efficiency Epsilon (sub chl) as the ratio of vegetation GPP as measured by eddy covariance techniques to PAR absorbed by chlorophyll (Epsilon(sub chl) = GPP/APAR (sub chl). Daily Epsilon (sub chl) retrieved with the EO-1 Hyperion images was regressed with a linear equation of PRI (sub nadir) Epsilon (sub chl) = Alpha × PRI (sub nadir) + Beta). The satellite Epsilon(sub chl- PRI (sub nadir) linear relationship for the cornfield was implemented to develop an integrated daily GPP model [GPP = (Alpha × PRI(sub nadir) + Beta) × fAPAR (sub chl) × PAR], which was evaluated with fAPAR (sub chl) and PRI (sub nadir) retrieved from field measurements. Daily GPP estimated with this fAPAR (sub chl-) PRI (nadir) integration model was strongly correlated with the observed tower in-situ daily GPP (R(sup 2) = 0.93); with a root mean square error (RMSE) of 1.71 g C mol-(sup -1) PPFD and coefficient of variation (CV) of 16

EOS Aqua: Mission Status at Earth Science Constellation

Science.gov (United States)

Guit, Bill

2016-01-01

This is an EOS Aqua Mission Status presentation to be given at the MOWG meeting in Albuquerque NM. The topics to discus are: mission summary, spacecraft subsystems summary, recent and planned activities, inclination adjust maneuvers, propellant usage and lifetime estimate, and mission summary.

Similarities and differences in coatings for magnesium-based stents and orthopaedic implants

Directory of Open Access Journals (Sweden)

Jun Ma

2014-07-01

Full Text Available Magnesium (Mg-based biodegradable materials are promising candidates for the new generation of implantable medical devices, particularly cardiovascular stents and orthopaedic implants. Mg-based cardiovascular stents represent the most innovative stent technology to date. However, these products still do not fully meet clinical requirements with regards to fast degradation rates, late restenosis, and thrombosis. Thus various surface coatings have been introduced to protect Mg-based stents from rapid corrosion and to improve biocompatibility. Similarly, different coatings have been used for orthopaedic implants, e.g., plates and pins for bone fracture fixation or as an interference screw for tendon-bone or ligament-bone insertion, to improve biocompatibility and corrosion resistance. Metal coatings, nanoporous inorganic coatings and permanent polymers have been proved to enhance corrosion resistance; however, inflammation and foreign body reactions have also been reported. By contrast, biodegradable polymers are more biocompatible in general and are favoured over permanent materials. Drugs are also loaded with biodegradable polymers to improve their performance. The key similarities and differences in coatings for Mg-based stents and orthopaedic implants are summarized.

Tribology considerations for hip joint articulations in relation to the "new orthopaedic patient".

Science.gov (United States)

Rieker, C B

2006-01-01

The purpose of this review is to examine alternative bearings used in total hip arthroplasty (THA) and discuss the specific tribologic needs of the "New Orthopaedic Patient". As orthopaedic patients today are younger and more active, there is a clear need for hip joint implants and articulations minimising the amount of wear and guarantying better stability. Recent modern developments in tribology with highly cross-linked polyethylenes and hard-on-hard bearings allow the safe and effective use of larger diameter articulations in THA.

Transient aphasia following spinal anaesthesia in an orthopaedic ...

African Journals Online (AJOL)

A 50-year-old male [American Society of Anesthesiologists (ASA) grade II] was scheduled for lower limb orthopaedic surgery. The subarachnoid space was localised with difficulty at L3/4 interspace and 3 ml of hyperbaric bupivacaine was given. Within a few minutes, the patient developed aphasia with a very high sensory ...

The use of EOS for studies of atmospheric physics

Energy Technology Data Exchange (ETDEWEB)

Gille, J G; Visconti, G [eds.

1992-01-01

Attention is paid to the atmosphere and how the understanding of its behavior could be facilitated by the observations and modeling of these interacting processes planned within the framework of the EOS (Earth Observing System) program. The Enrico Fermi School on which the book is based, was organized in such a way that general introductory lectures were followed by reviews of the planned EOS instruments and observational strategy to study specific components and processes in the earth atmosphere system. The contents are divided into four parts. Part 1 is an overview of the EOS concept and provides a general introduction to earth system science. Part 2 deals with the troposphere and includes a comprehensive introduction to the problems of tropospheric chemistry. The more traditional view of the troposphere as the stage for dynamics and meteorology is also dealt with. The climate system is discussed in detail in part 3, and includes the most important advances made in recent years in understanding some of these processes which have come from satellite observations. The final part deals with the middle atmosphere. The interest in ozone has made this region of the atmosphere the most closely studied in the last few years, in an attempt to establish how much of the changes in its composition may be attributable to natural variability and how much to anthropogenic influence

Stress and coping among orthopaedic surgery residents and faculty.

Science.gov (United States)

Sargent, M Catherine; Sotile, Wayne; Sotile, Mary O; Rubash, Harry; Barrack, Robert L

2004-07-01

Evaluations of physicians and residents have revealed concerning levels of psychosocial dysfunction. The purposes of this study were to determine the quality of life of orthopaedic residents and faculty and to identify the risk factors for decompensation. Twenty-one orthopaedic residents and twenty-five full-time orthopaedic faculty completed a 102-question voluntary, anonymous survey. The survey consisted of three validated instruments, i.e., the Maslach Burnout Inventory, the General Health Questionnaire-12, and the Revised Dyadic Adjustment Scale; and three novel question sets addressing background and demographic information, stress reaction and management, and the balance between work and home life. Descriptive statistics, pairwise correlations, simple t tests, and Pearson and nonparametric Spearman correlations were calculated. The simple correlation coefficient was used to assess bivariate relationships. The mean overall quality-of-life score, on a scale of 0 to 4 points, was 2.5 points for residents compared with 3.6 points for faculty members. Residents reported considerable burnout, showing a high level of emotional exhaustion and depersonalization and an average level of personal achievement, whereas faculty reported minimal burnout, showing a low level of emotional exhaustion (p burnout and psychiatric morbidity correlated with weekly work hours; conflict between the commitments of work and home life; discord with faculty, nursing staff, and senior residents; debt load; and work-related stress. Protective factors included being a parent, spending time with a spouse, having a physician father, and deriving satisfaction from discussing concerns with colleagues, friends, and family. In pursuit of our goal of determining the quality of life of orthopaedic residents and faculty, we identified a large disparity between the two groups. The resident group reported much greater levels of dysfunction particularly with regard to burnout and psychiatric morbidity

Does Medicaid Insurance Confer Adequate Access to Adult Orthopaedic Care in the Era of the Patient Protection and Affordable Care Act?

Science.gov (United States)

Labrum, Joseph T; Paziuk, Taylor; Rihn, Theresa C; Hilibrand, Alan S; Vaccaro, Alexander R; Maltenfort, Mitchell G; Rihn, Jeffrey A

2017-06-01

A current appraisal of access to orthopaedic care for the adult patient receiving Medicaid is important, since Medicaid expansion was written into law by the Patient Protection and Affordable Care Act (PPACA). (1) Do orthopaedic practices provide varying access to orthopaedic care for simulated patients with Medicaid insurance versus private insurance in a blinded survey? (2) What are the surveyed state-by-state Medicaid acceptance rates for adult orthopaedic practices in the current era of Medicaid expansion set forth by the PPACA? (3) Do surveyed rates of access to orthopaedic care in the adult patient population vary across practice setting (private vs academic) or vary with different Medicaid physician reimbursement rates? (4) Are there differences in the surveyed Medicaid acceptance rates for adult orthopaedic practices in states that have expanded Medicaid coverage versus states that have foregone expansion? Simulated Patient Survey: We performed a telephone survey study of orthopaedic offices in four states with Medicaid expansion. In the survey, the caller assumed a fictitious identity as a 38-year-old male who experienced an ankle fracture 1 day before calling, and attempted to secure an appointment within 2 weeks. During initial contact, the fictitious patient reported Medicaid insurance status. One month later, the fictitious patient contacted the same orthopaedic practice and reported private insurance coverage status. National Orthopaedic Survey: Private and academic orthopaedic practices operating in each state in the United States were called and asked to complete a survey assessing their practice model of Medicaid insurance acceptance. State reimbursement rates for three different Current Procedural Terminology (CPT ®) codes were collected from state Medicaid agencies. Results Simulated Patient Survey: Offices were less likely to accept Medicaid than commercial insurance (30 of 64 [47%] versus 62 of 64 [97%]; odds ratio [OR], 0.0145; 95% CI, 0

Evaluating the use of preoperative antibiotics in pediatric orthopaedic surgery.

Science.gov (United States)

Formaini, Nathan; Jacob, Paul; Willis, Leisel; Kean, John R

2012-01-01

To evaluate the rate of infection after minimally invasive procedures on a consecutive series of pediatric orthopaedic patients. We hypothesized that the use of preoperative antibiotics for minimally invasive pediatric orthopaedic procedures does not significantly reduce the incidence of surgical site infection requiring surgical debridement within 30 days of the primary procedure. We retrospectively reviewed 2330 patients having undergone minimally invasive orthopaedic procedures at our institution between March 2008 and November 2010. Knee arthroscopy, closed reduction with percutaneous fixation, soft tissue releases, excision of bony or soft-tissue masses, and removal of hardware constituted the vast majority of included procedures. Two groups, based on whether prophylactic antibiotics were administered before surgery, were created and the incidence of a repeat procedure required for deep infection was recorded. Statistical analysis was performed to determine significance, if any, between the 2 groups. Chart review of the 2330 patients identified 1087 as having received preoperative antibiotics, whereas the remaining 1243 patients did not receive antibiotics before surgery. Only 1 patient out of the 1243 cases in which antibiotics were not given required additional surgery within 30 days of the primary procedure due to a complicated surgical site infection (an incidence of 0.0008%). No patients in the antibiotic group developed a postoperative infection within 30 days requiring a return to the operating room for management. Our data revealed no significant increase in the incidence of complicated infection requiring additional procedures when antibiotics were not administered before surgery. Though prophylactic antibiotics have been shown to confer numerous benefits for patients undergoing relatively major operations, their use in cases of minimally invasive and/or percutaneous orthopaedic surgery is not well defined. Our data suggest that the use of

An evaluation of orthopaedic nurses’ participation in an educational intervention promoting research utilization – A triangulation convergence model

DEFF Research Database (Denmark)

Berthelsen, Connie Bøttcher; Hølge-Hazelton, Bibi

2016-01-01

Aims and objectives To describe the orthopaedic nurses' experiences regarding the relevance of an educational intervention and their personal and contextual barriers to participation in the intervention. Background One of the largest barriers against nurses' research usage in clinical practice...... is the lack of participation. A previous survey identified 32 orthopaedic nurses as interested in participating in nursing research. An educational intervention was conducted to increase the orthopaedic nurses' research knowledge and competencies. However, only an average of six nurses participated. Design...... A triangulation convergence model was applied through a mixed methods design to combine quantitative results and qualitative findings for evaluation. Methods Data were collected from 2013–2014 from 32 orthopaedic nurses in a Danish regional hospital through a newly developed 21-item questionnaire and two focus...

Three phase carbon EOS model with electronic excitation

International Nuclear Information System (INIS)

van Thiel, M.; Ree, F.H.; Grover, R.

1987-07-01

A simple and rapid way for computing EOS data of multiphase solids with a liquid phase is described with emphasis on carbon. The method uses a scaling model for the liquid phase and includes a provision for electronic effects. The free energy minimum determines the stable phase

Bone Graft Substitutes : Developed for Trauma and Orthopaedic Surgery

NARCIS (Netherlands)

J. van der Stok (Johan)

2015-01-01

markdownabstract__Abstract__ Bone grafting was established in the 19th century and has become a common procedure in which bone defects are filled with bone grafts or bone graft substitutes. Bone defects that require bone grafting are encountered in approximately 10% of trauma and orthopaedic

Earth Observing System/Meteorological Satellite (EOS/METSAT). Advanced Microwave Sounding Unit-A (AMSU-A) Contamination Control Plan

Science.gov (United States)

Fay, M.

1998-01-01

This Contamination Control Plan is submitted in response the Contract Document requirements List (CDRL) 007 under contract NAS5-32314 for the Earth Observing System (EOS) Advanced Microwave Sounding Unit A (AMSU-A). In response to the CDRL instructions, this document defines the level of cleanliness and methods/procedures to be followed to achieve adequate cleanliness/contamination control, and defines the required approach to maintain cleanliness/contamination control through shipping, observatory integration, test, and flight. This plan is also applicable to the Meteorological Satellite (METSAT) except where requirements are identified as EOS-specific. This plan is based on two key factors: a. The EOS/METSAT AMSU-A Instruments are not highly contamination sensitive. b. Potential contamination of other EOS Instruments is a key concern as addressed in Section 9/0 of the Performance Assurance Requirements for EOS/METSAT Integrated Programs AMSU-A Instrument (MR) (NASA Specification S-480-79).

44 CFR Appendix A to Part 9 - Decision-making Process for E.O. 11988

Science.gov (United States)

2010-10-01

... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Decision-making Process for E.O. 11988 A Appendix A to Part 9 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT..., App. A Appendix A to Part 9—Decision-making Process for E.O. 11988 EC02FE91.074 ...

Current Status of the LOFAR EoR Key Science Project

Science.gov (United States)

Koopmans, L. V. E.; LOFAR EoR KSP Team

2018-05-01

A short status update on the LOFAR Epoch of Reionization (EoR) Key Science Project (KSP) is given, regarding data acquisition, data processing and analysis, and current power-spectrum limits on the redshifted 21-cm signal of neutral hydrogen at redshifts z = 8 - 10. With caution, we present a preliminary astrophysical analysis of ~60 hr of processed LOFAR data and their resulting power spectrum, showing that potentially already interesting limits on X-ray heating during the Cosmic Dawn can already be gained. This is by no means the final analysis of this sub-set of data, but illustrates the future potential when all nearly 3000 hr of data in hand on two EoR windows will have been processed.

Demographics, nature and treatment of orthopaedic trauma injuries occurring in an agricultural context in the West of Ireland.

LENUS (Irish Health Repository)

Byrne, F J

2011-03-01

Farming is a major industry in the West of Ireland. This prospective study examined the age profile, nature and treatment of orthopaedic injuries occurring in agricultural surroundings presenting at the Orthopaedic Unit of Merlin Park Hospital, Galway.

Quality of life during orthopaedic training and academic practice: part 2: spouses and significant others.

Science.gov (United States)

Sargent, M Catherine; Sotile, Wayne; Sotile, Mary O; Rubash, Harry; Barrack, Robert L

2012-10-03

Orthopaedic residents and attending physicians who report having a supportive spouse show lower levels of burnout and psychological distress than those without supportive spouses. However, little is known about the experiences of the spouses. This nationwide study examines burnout, psychological distress, and marital satisfaction of the spouses and significant others (collectively referred to hereafter as spouses) of orthopaedists in training and in orthopaedic practice in an academic setting. Employing previously reported methodology, 259 spouses of orthopaedic residents and 169 spouses of full-time orthopaedic faculty completed a voluntary, anonymous survey. The survey included three validated instruments (the Maslach Burnout Inventory, the General Psychological Health Questionnaire-12, and the Revised Dyadic Adjustment Scale) and three novel question sets addressing demographic information, relationship issues, stress, and work/life balance. Psychological distress was noted in 18% of resident spouses compared with only 10% of faculty spouses (p = 0.014). Resident spouses reported greater loneliness (p < 0.0009) and stress (p = 0.03) than faculty spouses. Among working spouses, 30% of resident spouses and 13% of faculty spouses showed high levels of emotional exhaustion (p < 0.003). Twenty-eight percent of employed resident spouses and 5% of employed faculty spouses showed problematic levels of depersonalization (p < 0.0001). Twenty-six percent of employed resident spouses and 12% of employed faculty spouses showed a diminished sense of personal accomplishment (p = 0.012). Marital satisfaction was high for both resident and faculty spouses. Decreased satisfaction correlated with excessive mate irritability and fatigue that precluded their mate's involvement in family activities. A gratifying sex life, full-time work outside the home, and spending more than ninety minutes a day with their mate correlated significantly with marital satisfaction. Many orthopaedic

Non-Steroidal Anti Inflammatory Drugs Usage In Orthopaedics And ...

African Journals Online (AJOL)

Background: Non steroidal anti-inflammatory drugs NSAIDs) are a group of heterogeneous compounds with nti inflammatory, analgesic and often times anti pyretic roperties. They are weak organic acids and are the most commonly used drugs in Orthopaedic/Trauma practice. hey provide mild to moderate pain relief.

BSAVA Manual of Canine and Feline Musculoskeletal Imaging

DEFF Research Database (Denmark)

and a greater accessibility to cross-sectional imaging techniques the editors have included five new chapters covering the basics of the different imaging modalities with particular reference to their use in musculoskeletal imaging. Comparisons are drawn between the different techniques and a generous use...... edition a useful reference for orthopaedic surgeons and specialist radiologists. Additionally, there is an accompanying CD featuring video clips as well as all the images used throughout the manual....

Comparative Analysis of Dibutyric cAMP and Butyric Acid on the Differentiation of Human Eosinophilic Leukemia EoL-1 Cells.

Science.gov (United States)

Jung, YunJae

2015-12-01

Purification of enough numbers of circulating eosinophils is difficult because eosinophils account for less than 5% peripheral blood leukocytes. Human eosinophilic leukemia EoL-1 cells have been considered an in vitro source of eosinophils as they can differentiate into mature eosinophil-like cells when incubated with dibutyryl cAMP (dbcAMP) or butyric acid. In this study, the viability and phenotypic maturation of EoL-1 cells stimulated by either dbcAMP or butyric acid were comparatively analyzed. After treatment with 100 µM dbcAMP or 0.5 µM butyric acid, EoL-1 cells showed morphological signs of differentiation, although the number of nonviable EoL-1 cells was significantly increased following butyric acid treatment. Stimulation of EoL-1 cells with 0.5 µM butyric acid more effectively induced the expression of mature eosinophil markers than stimulation with dbcAMP. These results suggest that treatment of EoL-1 cells with 0.5 µM butyric acid for limited duration could be an effective strategy for inducing their differentiation. Considering that expression of CCR3 was not sufficient in EoL-1 cells stimulated with 0.5 µM butyric acid, treatment of the chemically stimulated EoL-1 cells with cytokines, which primarily support eosinophil maturation, would help to obtain differentiated EoL-1 cells with greater functional maturity.

Earth Observing System (EOS) Aqua Launch and Early Mission Attitude Support Experiences

Science.gov (United States)

Tracewell, D.; Glickman, J.; Hashmall, J.; Natanson, G.; Sedlak, J.

2003-01-01

The Earth Observing System (EOS) Aqua satellite was successfully launched on May 4,2002. Aqua is the second in the series of EOS satellites. EOS is part of NASA s Earth Science Enterprise Program, whose goals are to advance the scientific understanding of the Earth system. Aqua is a three-axis stabilized, Earth-pointing spacecraft in a nearly circular, sun-synchronous orbit at an altitude of 705 km. The Goddard Space Flight Center (GSFC) Flight Dynamics attitude team supported all phases of the launch and early mission. This paper presents the main results and lessons learned during this period, including: real-time attitude mode transition support, sensor calibration, onboard computer attitude validation, response to spacecraft emergencies, postlaunch attitude analyses, and anomaly resolution. In particular, Flight Dynamics support proved to be invaluable for successful Earth acquisition, fine-point mode transition, and recognition and correction of several anomalies, including support for the resolution of problems observed with the MODIS instrument.

Advanced practice physiotherapy-led triage in Irish orthopaedic and rheumatology services: national data audit.

Science.gov (United States)

Fennelly, Orna; Blake, Catherine; FitzGerald, Oliver; Breen, Roisin; Ashton, Jennifer; Brennan, Aisling; Caffrey, Aoife; Desmeules, François; Cunningham, Caitriona

2018-06-01

Many people with musculoskeletal (MSK) disorders wait several months or years for Consultant Doctor appointments, despite often not requiring medical or surgical interventions. To allow earlier patient access to orthopaedic and rheumatology services in Ireland, Advanced Practice Physiotherapists (APPs) were introduced at 16 major acute hospitals. This study performed the first national evaluation of APP triage services. Throughout 2014, APPs (n = 22) entered clinical data on a national database. Analysis of these data using descriptive statistics determined patient wait times, Consultant Doctor involvement in clinical decisions, and patient clinical outcomes. Chi square tests were used to compare patient clinical outcomes across orthopaedic and rheumatology clinics. A pilot study at one site identified re-referral rates to orthopaedic/rheumatology services of patients managed by the APPs. In one year, 13,981 new patients accessed specialist orthopaedic and rheumatology consultations via the APP. Median wait time for an appointment was 5.6 months. Patients most commonly presented with knee (23%), lower back (22%) and shoulder (15%) disorders. APPs made autonomous clinical decisions regarding patient management at 77% of appointments, and managed patient care pathways without onward referral to Consultant Doctors in more than 80% of cases. Other onward clinical pathways recommended by APPs were: physiotherapy referrals (42%); clinical investigations (29%); injections administered (4%); and surgical listing (2%). Of those managed by the APP, the pilot study identified that only 6.5% of patients were re-referred within one year. This national evaluation of APP services demonstrated that the majority of patients assessed by an APP did not require onward referral for a Consultant Doctor appointment. Therefore, patients gained earlier access to orthopaedic and rheumatology consultations in secondary care, with most patients conservatively managed.

Oral appliances and functional orthopaedic appliances for obstructive sleep apnoea in children.

Science.gov (United States)

Carvalho, F R; Lentini-Oliveira, D; Machado, M A C; Prado, G F; Prado, L B F; Saconato, H

2007-04-18

Apnoea is a breathing disorder marked by the absence of airflow at the nose or mouth. In children, risk factors include adenotonsillar hypertrophy, obesity, neuromuscular disorders and craniofacial anomalies. The most common treatment for obstructive sleep apnoea syndrome (OSAS) in childhood is adenotonsillectomy. This approach is limited by its surgical risks, mostly in children with comorbities and, in some patients, by recurrence that can be associated with craniofacial problems. Oral appliances and functional orthopaedic appliances have been used for patients who have OSAS and craniofacial anomalies because they change the mandible posture forwards and potentially enlarge the upper airway and increase the upper airspace, improving the respiratory function. To assess the effectiveness of oral appliances or functional orthopaedic appliances for OSAS in children. A sensitive search was developed for the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2005, Issue 3); PubMed (January 1966 to September 2005); EMBASE (1980 to September 2005); Lilacs (1982 to September 2005); BBO-Bibliografia Brasileira de Odontologia (1986 to September 2005); and SciELO (1997 to September 2005). There was no restriction of language or source of information. All randomised or quasi-randomised controlled trials comparing all types of oral and functional orthopaedic appliances with placebo or no treatment, in children 15 years old or younger. reduction of apnoea to less than one episode per hour. dental and skeletal relationship, sleep parameters improvement, cognitive and phonoaudiologic function, behavioural problems, drop outs and withdrawals, quality of life, side effects (tolerability), economic evaluation. Data were independently extracted by two review authors. Authors were contacted for additional information. Risk ratios with 95% confidence intervals were calculated for all important dichotomous outcomes. The initial search identified 384 trials

Fusion of Radar and EO-sensors for Surveillance

NARCIS (Netherlands)

Kester, L.J.H.M.; Theil, A.

2001-01-01

Fusion of radar and EO-sensors is investigated for the purpose of surveillance in littoral waters is. All sensors are considered to be co-located with respect to the distance, typically 1 to 10 km, of the area under surveillance. The sensor suite is a coherent polarimetric radar in combination with

Work-hour restrictions and orthopaedic resident education: a systematic review.

Science.gov (United States)

Mauser, Nathan S; Michelson, James D; Gissel, Hannah; Henderson, Corey; Mauffrey, Cyril

2016-05-01

The ACGME (US) and The European Working Time Directive (UK) placed work-hour restrictions on medical trainees with the goal of improved patient safety. However, there has been concern over a potential decrease in medical education. Orthopaedic training is the focus of this study. We examined previously published subjective and objective data regarding education and work-hour restrictions and developed the questions: Do specific perceptions emerge within the subjective studies examined? Are there objective differences in educational measures before and after work-hour restrictions? Is there a difference between the subjective and objective data? A systematic review was conducted via MedLine, regarding orthopaedic studies in the USA and UK, with reference to work-hour restrictions and education. Subjective survey studies demonstrate that residents and attending physicians have a negative response to work-hour restrictions because of the perceived impact on their overall education and operating room experience. Conversely, limited objective studies demonstrated no change in operative volume before or after implementation of restrictions. This review highlights the need for more objective studies on the educational implications of work-hour restrictions. Studies to date have not demonstrated a measurable difference based on case logs or training scores. Opinion-based surveys demonstrate an overall negative perception by both residents and attending physicians, on the impact of work-hour restrictions on orthopaedic education. Current published data is limited and stronger evidence-based data are needed before definitive conclusions can be reached.

Tactical EO/IE System for Ground Forces

Science.gov (United States)

1990-09-01

this thesis is based on these ideas. We will give the guidelines to a project manager or to a beginner in EW research about EO/IR system acquisition...1982 Syria vs Israel Syria: 1 Syria 5+ By Syria: 89 by 96+ Sparrow AIM-9G/L PYTHON Korea: 1 B- Kamchatka 1983 Korea vs USSR 0 0 747(KAL-(07) by AA-3 or

Motives for seeking a second opinion in orthopaedic surgery.

NARCIS (Netherlands)

Dalen, I. van; Groothoff, J.; Stewart, R.; Spreeuwenberg, P.; Groenewegen, P.; Horn, J. van

2001-01-01

The number of second opinions in orthopaedic surgery is increading rapidly, yet the grounds on which patients and their doctors decide to seek a second opinion have been little studied. The goal of the study was to identify patient and consultant factors that appeared to contribute to a second

Bone graft materials in fixation of orthopaedic implants in sheep

DEFF Research Database (Denmark)

Babiker, Hassan

2013-01-01

Bone graft is widely used within orthopaedic surgery especially in revision joint arthroplasty and spine fusion. The early implant fixation in the revision situation of loose joint prostheses is important for the long-term survival. Bone autograft has been considered as gold standard in many...... orthopaedic procedures, whereas allograft is the gold standard by replacement of extensive bone loss. However, the use of autograft is associated with donor site morbidity, especially chronic pain. In addition, the limited supply is a significant clinical challenge. Limitations in the use of allograft include...... the risk of bacterial contamination and disease transmission as well as non-union and poor bone quality. Other bone graft and substitutes have been considered as alternative in order to improve implant fixation. Hydroxyapatite and collagen type I composite (HA/Collagen) have the potential in mimicking...

Statistical Real-time Model for Performance Prediction of Ship Detection from Microsatellite Electro-Optical Imagers

Directory of Open Access Journals (Sweden)

Lapierre FabianD

2010-01-01

Full Text Available Abstract For locating maritime vessels longer than 45 meters, such vessels are required to set up an Automatic Identification System (AIS used by vessel traffic services. However, when a boat is shutting down its AIS, there are no means to detect it in open sea. In this paper, we use Electro-Optical (EO imagers for noncooperative vessel detection when the AIS is not operational. As compared to radar sensors, EO sensors have lower cost, lower payload, and better computational processing load. EO sensors are mounted on LEO microsatellites. We propose a real-time statistical methodology to estimate sensor Receiver Operating Characteristic (ROC curves. It does not require the computation of the entire image received at the sensor. We then illustrate the use of this methodology to design a simple simulator that can help sensor manufacturers in optimizing the design of EO sensors for maritime applications.

Technical evaluation of a CAD system for orthopaedic shoe-upper design.

Science.gov (United States)

Lord, M; Foulston, J; Smith, P J

1991-01-01

Computer aided design is now employed routinely in the volume shoe trade. New styles are developed on a three-dimensional image of the last followed by automated pattern generation and engineering. It is suggested that such systems could be useful in the orthopaedic footwear industry although the different requirements for these bespoke products need careful consideration. A clinical trial has been conducted on the Shoemaster (Clarks Shoes) upper design system both to assess its technical capabilities and to consider its role in improvement of service and cosmetic appearance. This particular system works throughout on a three-dimensional representation of the shoe last, which offers particular advantages for integration with shape capture and reproduction. The report concentrates on the technical evaluation to assess (a) its ability to work with unusual last shapes dictated by medical requirements and (b) its potential for integration into a complete computer system for design of both shoe lasts and shoe uppers. The trial indicates that this particular system is promising in both respects.

Electrostatic Discharge (ESD and Electrical Overstress (EOS: The state of the art in components to systems

Directory of Open Access Journals (Sweden)

Steven H. Voldman

2017-06-01

Full Text Available Electrostatic Discharge (ESD, Electrical Overstress (EOS and electromagnetic compatibility (EMC continue to impact semiconductor manufacturing, semiconductor components and systems as technologies scale from micro- to nano-electronics. The range of concern for components include semiconductor components, magnetic recording industry, MEMs, and for products from disk drives, cell phones, notebooks, tablets, laptops, and desktop computers. The objective of this lecture is to address the state of the art of electrostatic discharge (ESD and electrical overstress (EOS in today’s electronic components and systems. The tutorial provides a clear picture of ESD, EOS and EMC phenomena, sources, physics, failure mechanisms, testing and qualification of components and systems. The conclusion of this talk is that ESD and EOS continue to be a concern in technologies from micro-electronics to nano-structures, and will remain a reliability and quality issue in the future.

76 FR 31892 - Retrospective Review Under E.O. 13563

Science.gov (United States)

2011-06-02

..., Social Security Online, at http://www.socialsecurity.gov . SUPPLEMENTARY INFORMATION: On January 18, 2011... SOCIAL SECURITY ADMINISTRATION 20 CFR Chapter III [Docket No. SSA-2011-0042] Retrospective Review Under E.O. 13563 AGENCY: Social Security Administration. ACTION: Request for information. SUMMARY: In...

The impact of orthopaedic research evidence on health financing in Australia.

Science.gov (United States)

Hua, Martin; Myers, Daniel; Host, Lachlan

2018-05-02

In Australia, approval by the Medical Services Advisory Committee (MSAC) is an important step in the implementation of new health technologies. The MSAC considers health technology assessments (HTA) when submitting a recommendation to the Minister of Health on a new technology's suitability for public funding. Despite being such a critical tool in formulating policy, there has been little scrutiny on the impact of limited evidence on the performance of a national HTA agency's mandate. We aim to determine the proportion of HTAs of orthopaedic technologies prepared for the MSAC that were supported by higher levels of evidence for effectiveness, and whether this affected the MSAC's ability to conclude on efficacy. We also investigated whether the availability of higher level evidence affected the performance of cost-effectiveness analyses. We performed a cohort study of all HTAs prepared for the MSAC from 1998 to 2017 with regards to new technologies in orthopaedic surgery. We identified seven HTAs encompassing nine orthopaedic technologies for inclusion. Higher levels of evidence were available for assessing the technology's effectiveness in six out of the nine technologies. The results did not show a statistically significant relationship between the availability of higher level evidence and MSAC's ability to make a clear conclusion on the assessment of effectiveness (P = 0.5). The proportion of HTAs where a cost-effectiveness analysis was performed was significantly higher (P decision-making.

Database and Registry Research in Orthopaedic Surgery: Part I: Claims-Based Data.

Science.gov (United States)

Pugely, Andrew J; Martin, Christopher T; Harwood, Jared; Ong, Kevin L; Bozic, Kevin J; Callaghan, John J

2015-08-05

The use of large-scale national databases for observational research in orthopaedic surgery has grown substantially in the last decade, and the data sets can be grossly categorized as either administrative claims or clinical registries. Administrative claims data comprise the billing records associated with the delivery of health-care services. Orthopaedic researchers have used both government and private claims to describe temporal trends, geographic variation, disparities, complications, outcomes, and resource utilization associated with both musculoskeletal disease and treatment. Medicare claims comprise one of the most robust data sets used to perform orthopaedic research, with >45 million beneficiaries. The U.S. government, through the Centers for Medicare & Medicaid Services, often uses these data to drive changes in health policy. Private claims data used in orthopaedic research often comprise more heterogeneous patient demographic samples, but allow longitudinal analysis similar to that offered by Medicare claims. Discharge databases, such as the U.S. National Inpatient Sample, provide a wide national sampling of inpatient hospital stays from all payers and allow analysis of associated adverse events and resource utilization. Administrative claims data benefit from the high patient numbers obtained through a majority of hospitals. Using claims, it is possible to follow patients longitudinally throughout encounters irrespective of the location of the institution delivering health care. Some disadvantages include lack of precision of ICD-9 (International Classification of Diseases, Ninth Revision) coding schemes. Much of these data are expensive to purchase, complicated to organize, and labor-intensive to manipulate--often requiring trained specialists for analysis. Given the changing health-care environment, it is likely that databases will provide valuable information that has the potential to influence clinical practice improvement and health policy for

A Perspective on the Effect of the 80-Hour Work Week: Has It Changed the Graduating Orthopaedic Resident?

Science.gov (United States)

Pellegrini, Vincent D

2017-06-01

Orthopaedic residency education has changed substantially in recent decades because of the imposition of the 80-hour work week, a decrease in quality and quantity of general surgical education, regulations mandating closer trainee supervision, and an expansion of orthopaedic subspecialty rotations. These factors pose a challenge in efforts to prepare competent, confident, cautious, caring, and communicative orthopaedic residents within the traditional 5-year program. Evidence suggests that contemporary graduates are more intelligent, better balanced in life and work, and more in touch with humanistic aspects of medicine than were earlier graduates. Yet insufficient competence and confidence in surgical skills after residency and a lack of "ownership" of patient care have become an increasing concern of educators and trainees. The concept of 10,000 hours of deliberate practice to achieve mastery of a technical skill applies to orthopaedic residency education. A different approach to graduate medical education must address the critical minimum training time required to achieve the necessary skills to support independent medical and surgical practice.

EOS as the present and future solution for data storage at CERN

CERN Document Server

Peters, AJ; Adde, G

2015-01-01

EOS is an open source distributed disk storage system in production since 2011 at CERN. Development focus has been on low-latency analysis use cases for LHC(1) and non- LHC experiments and life-cycle management using JBOD(2) hardware for multi PB storage installations. The EOS design implies a split of hot and cold storage and introduced a change of the traditional HSM(3) functionality based workflows at CERN.The 2015 deployment brings storage at CERN to a new scale and foresees to breach 100 PB of disk storage in a distributed environment using tens of thousands of (heterogeneous) hard drives. EOS has brought to CERN major improvements compared to past storage solutions by allowing quick changes in the quality of service of the storage pools. This allows the data centre to quickly meet the changing performance and reliability requirements of the LHC experiments with minimal data movements and dynamic reconfiguration. For example, the software stack has met the specific needs of the dual computing centre set-...

Ambulatory orthopaedic surgery patients' emotions when using different patient education methods.

Science.gov (United States)

Heikkinen, Katja; Salanterä, Sanna; Leppänen, Tiina; Vahlberg, Tero; Leino-Kilpi, Helena

2012-07-01

A randomised controlled trial was used to evaluate elective ambulatory orthopaedic surgery patients' emotions during internet-based patient education or face-to-face education with a nurse. The internet-based patient education was designed for this study and patients used websites individually based on their needs. Patients in the control group participated individually in face-to-face patient education with a nurse in the ambulatory surgery unit. The theoretical basis for both types of education was the same. Ambulatory orthopaedic surgery patients scored their emotions rather low at intervals throughout the whole surgical process, though their scores also changed during the surgical process. Emotion scores did not decrease after patient education. No differences in patients' emotions were found to result from either of the two different patient education methods.

Prospective assessment of NSAIDs induced ADRs in orthopaedic in-patients

Directory of Open Access Journals (Sweden)

Padmanabha TS, Bhaskara K, Nandini T

2014-04-01

Full Text Available Background and Objectives: nonsteroidal anti-inflammatory drugs (NSAIDs are one among the most widely used medications to treat pain and inflammation condition. But inadvertent use of NSAIDs have resulted in gastric upset and even death. Hence to minimize such consequences and to identify the incidence of the Adverse drug reaction (ADRs due to NSAIDs in orthopaedic in-patients to promote rational prescribing. Materials and Methods: A prospective study was done in one hundred orthopaedic in-patients of a tertiary care hospital for 3 months from June-Augest 2012. The ADRs pattern were noted with respect to age, gender and drugs involved . The causality of ADRs were assessed by Naranjo’s Algorithm. Results: Among one hundred in- patients 16% developed ADR due to NSAIDs and 1.92% due to Antimicrobial agents (AMAs. The ADRs were more in males (11% than females (5%. Most prescribed NSAID was Diclofenac (76 %, and least was nimesulide (2%. Others were Paracetamol (16%, Ibuprofen (3% and Etoricoxib (3% . Out of 16 ADRs Tablet (Tab Diclofenac accounted for maximum number {87.5%, (n=14} of ADRs, followed by Tab. Paracetamol {12.5 % (n=2}. Conclusion: ADR incidence rate in orthopaedic in-patient due to NSAIDs was 16%. Educating, establishment and encouragement of Pharmacovigilance system among medical and non-health professionals including medical undergraduates improve ADRs identification and to identify the drugs causing it, therefore prolonged hospitalization, treatment cost, morbidity and mortalities can be minimized. Hence, further ADRs due to particular drugs can be reduced in other patients with rational prescription.

Evaluation of the content and accessibility of web sites for accredited orthopaedic sports medicine fellowships.

Science.gov (United States)

Mulcahey, Mary K; Gosselin, Michelle M; Fadale, Paul D

2013-06-19

The Internet is a common source of information for orthopaedic residents applying for sports medicine fellowships, with the web sites of the American Orthopaedic Society for Sports Medicine (AOSSM) and the San Francisco Match serving as central databases. We sought to evaluate the web sites for accredited orthopaedic sports medicine fellowships with regard to content and accessibility. We reviewed the existing web sites of the ninety-five accredited orthopaedic sports medicine fellowships included in the AOSSM and San Francisco Match databases from February to March 2012. A Google search was performed to determine the overall accessibility of program web sites and to supplement information obtained from the AOSSM and San Francisco Match web sites. The study sample consisted of the eighty-seven programs whose web sites connected to information about the fellowship. Each web site was evaluated for its informational value. Of the ninety-five programs, fifty-one (54%) had links listed in the AOSSM database. Three (3%) of all accredited programs had web sites that were linked directly to information about the fellowship. Eighty-eight (93%) had links listed in the San Francisco Match database; however, only five (5%) had links that connected directly to information about the fellowship. Of the eighty-seven programs analyzed in our study, all eighty-seven web sites (100%) provided a description of the program and seventy-six web sites (87%) included information about the application process. Twenty-one web sites (24%) included a list of current fellows. Fifty-six web sites (64%) described the didactic instruction, seventy (80%) described team coverage responsibilities, forty-seven (54%) included a description of cases routinely performed by fellows, forty-one (47%) described the role of the fellow in seeing patients in the office, eleven (13%) included call responsibilities, and seventeen (20%) described a rotation schedule. Two Google searches identified direct links for

Establishing a children's orthopaedic hospital for Malawi: A review ...

African Journals Online (AJOL)

At present the program has a total of 29 clinics, which .... Thus a total of 1154 paediatric orthopaedic operations were known to have taken place in Malawi during the 10th year of operational services with 53% of cases being performed at BCIH. ... regional hip replacement course, 1 regional knee replacement course for ...

The Libyan civil conflict: selected case series of orthopaedic trauma managed in Malta in 2014.

Science.gov (United States)

Ng, Colin; Mifsud, Max; Borg, Joseph N; Mizzi, Colin

2015-11-20

The purpose of this series of cases was to analyse our management of orthopaedic trauma casualties in the Libyan civil war crisis in the European summer of 2014. We looked at both damage control orthopaedics and for case variety of war trauma at a civilian hospital. Due to our geographical proximity to Libya, Malta was the closest European tertiary referral centre. Having only one Level 1 trauma care hospital in our country, our Trauma and Orthopaedics department played a pivotal role in the management of Libyan battlefield injuries. Our aims were to assess acute outcomes and short term mortality of surgery within the perspective of a damage control orthopaedic strategy whereby aggressive wound management, early fixation using relative stability principles, antibiotic cover with adequate soft tissue cover are paramount. We also aim to describe the variety of war injuries we came across, with a goal for future improvement in regards to service providing. Prospective collection of six interesting cases with severe limb and spinal injuries sustained in Libya during the Libyan civil war between June and November 2014. We applied current trends in the treatment of war injuries, specifically in damage control orthopaedic strategy and converting to definitive treatment where permissible. The majority of our cases were classified as most severe (Type IIIB/C) according to the Gustilo-Anderson classification of open fractures. The injuries treated reflected the type of standard and improved weaponry available in modern warfare affecting both militants and civilians alike with increasing severity and extent of damage. Due to this fact, multidisciplinary team approach to patient centred care was utilised with an ultimate aim of swift recovery and early mobilisation. It also highlighted the difficulties and complex issues required on a hospital management level as a neighbouring country to war zone countries in transforming care of civil trauma to military trauma.

The effect of inclement weather on trauma orthopaedic workload.

LENUS (Irish Health Repository)

Cashman, J P

2012-01-31

BACKGROUND: Climate change models predict increasing frequency of extreme weather. One of the challenges hospitals face is how to make sure they have adequate staffing at various times of the year. AIMS: The aim of this study was to examine the effect of this severe inclement weather on hospital admissions, operative workload and cost in the Irish setting. We hypothesised that there is a direct relationship between cold weather and workload in a regional orthopaedic trauma unit. METHODS: Trauma orthopaedic workload in a regional trauma unit was examined over 2 months between December 2009 and January 2010. This corresponded with a period of severe inclement weather. RESULTS: We identified a direct correlation between the drop in temperature and increase in workload, with a corresponding increase in demand on resources. CONCLUSIONS: Significant cost savings could be made if these injuries were prevented. While the information contained in this study is important in the context of resource planning and staffing of hospital trauma units, it also highlights the vulnerability of the Irish population to wintery weather.

Towards an EO-based Landslide Web Mapping and Monitoring Service

Science.gov (United States)

Hölbling, Daniel; Weinke, Elisabeth; Albrecht, Florian; Eisank, Clemens; Vecchiotti, Filippo; Friedl, Barbara; Kociu, Arben

2017-04-01

National and regional authorities and infrastructure maintainers in mountainous regions require accurate knowledge of the location and spatial extent of landslides for hazard and risk management. Information on landslides is often collected by a combination of ground surveying and manual image interpretation following landslide triggering events. However, the high workload and limited time for data acquisition result in a trade-off between completeness, accuracy and detail. Remote sensing data offers great potential for mapping and monitoring landslides in a fast and efficient manner. While facing an increased availability of high-quality Earth Observation (EO) data and new computational methods, there is still a lack in science-policy interaction and in providing innovative tools and methods that can easily be used by stakeholders and users to support their daily work. Taking up this issue, we introduce an innovative and user-oriented EO-based web service for landslide mapping and monitoring. Three central design components of the service are presented: (1) the user requirements definition, (2) the semi-automated image analysis methods implemented in the service, and (3) the web mapping application with its responsive user interface. User requirements were gathered during semi-structured interviews with regional authorities. The potential users were asked if and how they employ remote sensing data for landslide investigation and what their expectations to a landslide web mapping service regarding reliability and usability are. The interviews revealed the capability of our service for landslide documentation and mapping as well as monitoring of selected landslide sites, for example to complete and update landslide inventory maps. In addition, the users see a considerable potential for landslide rapid mapping. The user requirements analysis served as basis for the service concept definition. Optical satellite imagery from different high resolution (HR) and very high

Design of a nickel-hydrogen battery simulator for the NASA EOS testbed

Science.gov (United States)

Gur, Zvi; Mang, Xuesi; Patil, Ashok R.; Sable, Dan M.; Cho, Bo H.; Lee, Fred C.

1992-01-01

The hardware and software design of a nickel-hydrogen (Ni-H2) battery simulator (BS) with application to the NASA Earth Observation System (EOS) satellite is presented. The battery simulator is developed as a part of a complete testbed for the EOS satellite power system. The battery simulator involves both hardware and software components. The hardware component includes the capability of sourcing and sinking current at a constant programmable voltage. The software component includes the capability of monitoring the battery's ampere-hours (Ah) and programming the battery voltage according to an empirical model of the nickel-hydrogen battery stored in a computer.

Automatic registration of panoramic image sequence and mobile laser scanning data using semantic features

Science.gov (United States)

Li, Jianping; Yang, Bisheng; Chen, Chi; Huang, Ronggang; Dong, Zhen; Xiao, Wen

2018-02-01

Inaccurate exterior orientation parameters (EoPs) between sensors obtained by pre-calibration leads to failure of registration between panoramic image sequence and mobile laser scanning data. To address this challenge, this paper proposes an automatic registration method based on semantic features extracted from panoramic images and point clouds. Firstly, accurate rotation parameters between the panoramic camera and the laser scanner are estimated using GPS and IMU aided structure from motion (SfM). The initial EoPs of panoramic images are obtained at the same time. Secondly, vehicles in panoramic images are extracted by the Faster-RCNN as candidate primitives to be matched with potential corresponding primitives in point clouds according to the initial EoPs. Finally, translation between the panoramic camera and the laser scanner is refined by maximizing the overlapping area of corresponding primitive pairs based on the Particle Swarm Optimization (PSO), resulting in a finer registration between panoramic image sequences and point clouds. Two challenging urban scenes were experimented to assess the proposed method, and the final registration errors of these two scenes were both less than three pixels, which demonstrates a high level of automation, robustness and accuracy.

Using simulation to train orthopaedic trainees in non-technical skills: A pilot study.

Science.gov (United States)

Heaton, Samuel R; Little, Zoe; Akhtar, Kash; Ramachandran, Manoj; Lee, Joshua

2016-08-18

To enhance non-technical skills and to analyse participant's experience of a course tailored for orthopaedic surgeons. A Delphi technique was used to develop a course in human factors specific to orthopaedic residents. Twenty-six residents (six per course) participated in total with seven course facilitators all trained in Crisis Resource Management providing structured feedback. Six scenarios recreated challenging real-life situations using high-fidelity mannequins and simulated patients. Environments included a simulated operating suite, clinic room and ward setting. All were undertaken in a purpose built simulation suite utilising actors, mock operating rooms, mock clinical rooms and a high fidelity adult patient simulator organised through a simulation control room. Participants completed a 5-point Likert scale questionnaire (strongly disagree to strongly agree) before and after the course. This assessed their understanding of non-technical skills, scenario validity, relevance to orthopaedic training and predicted impact of the course on future practice. A course evaluation questionnaire was also completed to assess participants' feedback on the value and quality of the course itself. Twenty-six orthopaedic residents participated (24 male, 2 female; post-graduation 5-10 years), mean year of residency program 2.6 out of 6 years required in the United Kingdom. Pre-course questionnaires showed that while the majority of candidates recognised the importance of non-technical (NT) skills in orthopaedic training they demonstrated poor understanding of non-technical skills and their role. This improved significantly after the course (Likert score 3.0-4.2) and the perceived importance of these skills was reported as good or very good in 100%. The course was reported as enjoyable and provided an unthreatening learning environment with the candidates placing particular value on the learning opportunity provided by reflecting on their performance. All agreed that the

Substantial variation in the interpretation of financial disclosure policies for orthopaedic society meetings.

Science.gov (United States)

Jegede, Kolawole; Whang, Peter; Grauer, Jonathan N

2011-07-06

Physician disclosure of potential conflicts of interest is currently controversial. To address this issue, orthopaedic societies have implemented a variety of guidelines related to potential conflict-of-interest disclosure. Transparency is crucial to address the concerns about potential conflict-of-interest disclosure. Nonetheless, prior studies have noted substantial discrepancies in disclosures to societies for individual authors who present their research work at multiple conferences. Our goal was to evaluate the ability of orthopaedic surgeons to interpret disclosure policy statements regarding project-specific or global disclosure instructions. The disclosure policy statements of the ten conferences most frequently attended by this group were collected, and selected statements were compiled into a questionnaire survey that was administered to orthopaedic faculty and trainees at our institution. Subjects were asked to read each statement and identify whether they interpreted the policy to be requesting project-specific disclosures (potential conflict of interest related to the research work in the abstract being submitted) or global disclosure (inclusive of all potential conflicts of interest, including those not associated with the abstract being submitted). The correct responses were identified by communicating with the individual societies and determining the responses desired by the society. The study had a 100% return rate from seventeen orthopaedic faculty, twenty-five orthopaedic residents and fellows, and twenty-five medical students. The average number of incorrect responses to the ten questions was 2.8. Forty-six percent of respondents had three or more incorrect responses, 24% had two incorrect responses, 19% had one incorrect response, and 10% had no incorrect responses. There was no significant difference in responses between those of different training levels. Subjects were no more likely to answer a project-specific question incorrectly than they

Registration of clinical volumes to beams-eye-view images for real-time tracking

Energy Technology Data Exchange (ETDEWEB)

Bryant, Jonathan H.; Rottmann, Joerg; Lewis, John H.; Mishra, Pankaj; Berbeco, Ross I., E-mail: rberbeco@lroc.harvard.edu [Department of Radiation Oncology, Brigham and Women’s Hospital, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts 02115 (United States); Keall, Paul J. [Radiation Physics Laboratory, Sydney Medical School, University of Sydney, Sydney, New South Wales 2006 (Australia)

2014-12-15

Purpose: The authors combine the registration of 2D beam’s eye view (BEV) images and 3D planning computed tomography (CT) images, with relative, markerless tumor tracking to provide automatic absolute tracking of physician defined volumes such as the gross tumor volume (GTV). Methods: During treatment of lung SBRT cases, BEV images were continuously acquired with an electronic portal imaging device (EPID) operating in cine mode. For absolute registration of physician-defined volumes, an intensity based 2D/3D registration to the planning CT was performed using the end-of-exhale (EoE) phase of the four dimensional computed tomography (4DCT). The volume was converted from Hounsfield units into electron density by a calibration curve and digitally reconstructed radiographs (DRRs) were generated for each beam geometry. Using normalized cross correlation between the DRR and an EoE BEV image, the best in-plane rigid transformation was found. The transformation was applied to physician-defined contours in the planning CT, mapping them into the EPID image domain. A robust multiregion method of relative markerless lung tumor tracking quantified deviations from the EoE position. Results: The success of 2D/3D registration was demonstrated at the EoE breathing phase. By registering at this phase and then employing a separate technique for relative tracking, the authors are able to successfully track target volumes in the BEV images throughout the entire treatment delivery. Conclusions: Through the combination of EPID/4DCT registration and relative tracking, a necessary step toward the clinical implementation of BEV tracking has been completed. The knowledge of tumor volumes relative to the treatment field is important for future applications like real-time motion management, adaptive radiotherapy, and delivered dose calculations.

The 2007 ABJS Marshall Urist Award: The impact of direct-to-consumer advertising in orthopaedics.

Science.gov (United States)

Bozic, Kevin J; Smith, Amanda R; Hariri, Sanaz; Adeoye, Sanjo; Gourville, John; Maloney, William J; Parsley, Brian; Rubash, Harry E

2007-05-01

Direct-to-consumer advertising (DTCA) has become an influential factor in healthcare delivery in the United States. We evaluated the influence of DTCA on surgeon and patient opinions and behavior in orthopaedics by surveying orthopaedic surgeons who perform hip and knee arthroplasties and patients who were scheduled to have hip or knee arthro-plasty. Respondents were asked for their opinions of and experiences with DTCA, including the influence of DTCA on surgeon and patient decision making. Greater than 98% of surgeon respondents had experience with patients who were exposed to DTCA. The majority of surgeon respondents reported DTCA had an overall negative impact on their practice and their interaction with patients (74%), and their patients often were confused or misinformed about the appropriate treatment for their condition based on an advertisement (77%). Fifty-two percent of patient respondents recalled seeing or hearing advertisements related to hip or knee arthroplasty. These patients were more likely to request a specific type of surgery or brand of implant from their surgeon and to see more than one surgeon before deciding to have surgery. Direct-to-consumer advertising seems to play a substantial role in surgeon and patient decision making in orthopaedics. Future efforts should be aimed at improving the quality and accuracy of information contained in consumer-directed advertisements related to orthopaedic implants and procedures.

A systematic survey of the quality of research reporting in general orthopaedic journals.

Science.gov (United States)

Parsons, N R; Hiskens, R; Price, C L; Achten, J; Costa, M L

2011-09-01

The poor reporting and use of statistical methods in orthopaedic papers has been widely discussed by both clinicians and statisticians. A detailed review of research published in general orthopaedic journals was undertaken to assess the quality of experimental design, statistical analysis and reporting. A representative sample of 100 papers was assessed for compliance to CONSORT and STROBE guidelines and the quality of the statistical reporting was assessed using a validated questionnaire. Overall compliance with CONSORT and STROBE guidelines in our study was 59% and 58% respectively, with very few papers fulfilling all criteria. In 37% of papers patient numbers were inadequately reported; 20% of papers introduced new statistical methods in the 'results' section not previously reported in the 'methods' section, and 23% of papers reported no measurement of error with the main outcome measure. Taken together, these issues indicate a general lack of statistical rigour and are consistent with similar reviews undertaken in a number of other scientific and clinical research disciplines. It is imperative that the orthopaedic research community strives to improve the quality of reporting; a failure to do so could seriously limit the development of future research.

99m Tc-labeled heparin test in orthopaedic surgery

International Nuclear Information System (INIS)

Bouvier, J.F.; Lafon, J.C.; Colin, M.; Chatelut, J.; Beaubatie, F.

1983-01-01

99m Tc-labeled heparin test was performed for early detection of phlebitis or pulmonary embolism after orthopaedic prothesis. Heparinic treatment and surgery per se were demonstrated to have no effect on the results. If this test demonstrates a statistical difference for pathologic patients, it is of greater value to consider ratio between rates before and after intervention [fr

Orthopaedic Section Poster Presentations (Abstracts OPO1-OPO300).

Science.gov (United States)

2018-01-01

These abstracts are presented here as prepared by the authors. The accuracy and content of each abstract remain the responsibility of the authors. In the identification number above each abstract, OPO designates an Orthopaedic Section poster presentation. J Orthop Sports Phys Ther 2018;48(1):A67-A202. doi:10.2519/jospt.2018.48.1.A67.

Rapid Prototyping in Orthopaedic Surgery: A User's Guide

OpenAIRE

Frame, Mark; Huntley, James S.

2012-01-01

Rapid prototyping (RP) is applicable to orthopaedic problems involving three dimensions, particularly fractures, deformities, and reconstruction. In the past, RP has been hampered by cost and difficulties accessing the appropriate expertise. Here we outline the history of rapid prototyping and furthermore a process using open-source software to produce a high fidelity physical model from CT data. This greatly mitigates the expense associated with the technique, allowing surgeons to produce pr...

Patient-family EoL communication and its predictors: Reports from caregivers of Latino patients in the rural U.S.-Mexico border region.

Science.gov (United States)

Ko, Eunjeong; Lee, Jaehoon; Ramirez, Carlos; Lopez, Denicka; Martinez, Stephanie

2017-10-26

Family caregivers play an important role in end-of-life (EoL) decision making when the patient is unable to make his/her own decisions. While communication about EoL care between patients and family is perhaps a first step toward advance care planning (ACP)/EoL decisions, not every culture puts great value on open communication about this topic. The aims of the present study were to explore EoL communication and the aspects of communication among caregivers of Latino patients in the rural United States (U.S.)-Mexico border region. This study analyzed data from a hospice needs assessment collected from 189 family caregivers of Latino patients at a home health agency in a rural U.S.-Mexico border region. Bivariate tests and logistic regression were used to address our aims. About half of the family caregivers (n = 96, 50.8%) reported to have ever engaged in EoL discussion with patients. Significant predictors of EoL discussion included life-sustaining treatment preference (odds ratio [OR] = 0.44, p EoL communication. Also, caregivers who worried that physicians might want to stop treatments (i.e., "pull the plug") too soon were less likely to do so. Conversely, caregivers who had knowledge about ADs were more likely to engage in EoL communication. EoL communication is a complex process influenced by individual, social, and cultural values and the beliefs of both the patient and his/her family. Inclusion of family caregivers in the ACP process and facilitating culturally tailored EoL communication between patients and family caregivers is important.

Tribology of total hip arthroplasty prostheses: What an orthopaedic surgeon should know.

Science.gov (United States)

Rieker, Claude B

2016-02-01

Articulating components should minimise the generation of wear particles in order to optimize long-term survival of the prosthesis.A good understanding of tribological properties helps the orthopaedic surgeon to choose the most suitable bearing for each individual patient.Conventional and highly cross-linked polyethylene articulating either with metal or ceramic, ceramic-on-ceramic and metal-on-metal are the most commonly used bearing combinations.All combinations of bearing surface have their advantages and disadvantages. An appraisal of the individual patient's objectives should be part of the assessment of the best bearing surface. Cite this article: Rieker CB. Tribology of total hip arthroplasty prostheses: what an orthopaedic surgeon should know. EFORT Open Rev 2016;1:52-57. DOI: 10.1302/2058-5241.1.000004.

The long periodicity phase (LPP) controversy part I: The influence of a natural-like ratio of the CER[EOS] analogue [EOS]-br in a CER[NP]/[AP] based stratum corneum modelling system: A neutron diffraction study.

Science.gov (United States)

Schmitt, Thomas; Lange, Stefan; Sonnenberger, Stefan; Dobner, Bodo; Demé, Bruno; Langner, Andreas; Neubert, Reinhard H H

2018-06-18

This study used neutron diffraction to investigate a ceramide-[NP] C24/[AP] C24 /[EOS]-br C30/cholesterol/lignoceric acid (0.6: 0.3: 0.1: 0.7: 1) based stratum corneum modelling system. By adding specifically deuterated ceramides-[NP]-D 3 , [AP]-D 3 , and [EOS]-br-D 3 , detailed information on the lamellar and the nanostructure of the system was obtained. For the short periodicity phase a natural-like lamellar repeat distance of 5.47 ± 0.02 nm was observed, similar to the [NP]/[AP] base system without the [EOS]-br. Unlike in this system the ceramides here were slightly tilted, hinting towards a slightly less natural arrangement. Due to the deuteration it was possible to observe that the long ceramide chains were overlapping in the lamellar mid-plane. This is considered to be an important feature for the natural stratum corneum. Despite the presence of a ceramide [EOS] analogue - able to form a long phase arrangement - no distinct long periodicity phase was formed, despite a slightly higher than natural ω-acyl ceramide ratio of 10 mol%. The deuterated variant of this ceramide determined that the very long ceramide was integrated into the short periodicity phase, spanning multiple layers instead. The - compared to the base system - unchanged repeat distance highlights the stability of this structure. Furthermore, the localisation of the very long ceramide in the short periodicity phase indicates the possibility of a crosslinking effect and thus a multilayer stabilizing role for the ceramide [EOS]. It can be concluded, that additionally to the mere presence of ceramide-[EOS] more complex conditions have to be met in order to form this long phase. This has to be further investigated in the future. Copyright © 2018 Elsevier B.V. All rights reserved.

House dust mite induces expression of intercellular adhesion molecule-1 in EoL-1 human eosinophilic leukemic cells.

Science.gov (United States)

Kwon, Byoung Chul; Sohn, Myung Hyun; Kim, Kyung Won; Kim, Eun Soo; Kim, Kyu-Earn; Shin, Myeong Heon

2007-10-01

The house dust mite (HDM) is considered to be the most common indoor allergen associated with bronchial asthma. In this study, we investigated whether crude extract of the HDM Dermatophagoides farinae could activate human eosinophilic leukemic cells (EoL-1) to induce upregulation of cell-surface adhesion molecules. When EoL-1 cells were incubated with D. farinae extract, expression of intercellular adhesion molecule-1 (ICAM-1) significantly increased on the cell surfaces compared to cells incubated with medium alone. In contrast, surface expression of CD11b and CD49d in EoL-1 cells was not affected by D. farinae extract. In addition, pretreatment of cells with NF-kappaB inhibitor (MG-132) or JNK inhibitor (SP600125) significantly inhibited ICAM-1 expression promoted by HDM extract. However, neither p38 MAP kinase inhibitor nor MEK inhibitor prevented HDM-induced ICAM-1 expression in EoL-1 cells. These results suggest that crude extract of D. farinae induces ICAM-1 expression in EoL-1 cells through signaling pathways involving both NF-kappaB and JNK.

21SSD: a new public 21-cm EoR database

Science.gov (United States)

Eames, Evan; Semelin, Benoît

2018-05-01

With current efforts inching closer to detecting the 21-cm signal from the Epoch of Reionization (EoR), proper preparation will require publicly available simulated models of the various forms the signal could take. In this work we present a database of such models, available at 21ssd.obspm.fr. The models are created with a fully-coupled radiative hydrodynamic simulation (LICORICE), and are created at high resolution (10243). We also begin to analyse and explore the possible 21-cm EoR signals (with Power Spectra and Pixel Distribution Functions), and study the effects of thermal noise on our ability to recover the signal out to high redshifts. Finally, we begin to explore the concepts of `distance' between different models, which represents a crucial step towards optimising parameter space sampling, training neural networks, and finally extracting parameter values from observations.

Hydrolytic Decomposition in a Polyamide/PDMS Composite for Orthopaedic Usage

Czech Academy of Sciences Publication Activity Database

Sochor, M.; Balík, Karel; Sucharda, Zbyněk; Suchý, Tomáš; Sedláček, R.

2011-01-01

Roč. 14, č. 103 (2011), s. 2-3 ISSN 1429-7248 R&D Projects: GA ČR(CZ) GAP108/10/1457 Institutional research plan: CEZ:AV0Z30460519 Keywords : composite * hydrolic decomposition * orthopaedics Subject RIV: BO - Biophysics http://www.biomat.krakow.pl/gazeta/archiwum/103.pdf

The orthopaedic error index: development and application of a novel national indicator for assessing the relative safety of hospital care using a cross-sectional approach.

Science.gov (United States)

Panesar, Sukhmeet S; Netuveli, Gopalakrishnan; Carson-Stevens, Andrew; Javad, Sundas; Patel, Bhavesh; Parry, Gareth; Donaldson, Liam J; Sheikh, Aziz

2013-11-21

The Orthopaedic Error Index for hospitals aims to provide the first national assessment of the relative safety of provision of orthopaedic surgery. Cross-sectional study (retrospective analysis of records in a database). The National Reporting and Learning System is the largest national repository of patient-safety incidents in the world with over eight million error reports. It offers a unique opportunity to develop novel approaches to enhancing patient safety, including investigating the relative safety of different healthcare providers and specialties. We extracted all orthopaedic error reports from the system over 1 year (2009-2010). The Orthopaedic Error Index was calculated as a sum of the error propensity and severity. All relevant hospitals offering orthopaedic surgery in England were then ranked by this metric to identify possible outliers that warrant further attention. 155 hospitals reported 48 971 orthopaedic-related patient-safety incidents. The mean Orthopaedic Error Index was 7.09/year (SD 2.72); five hospitals were identified as outliers. Three of these units were specialist tertiary hospitals carrying out complex surgery; the remaining two outlier hospitals had unusually high Orthopaedic Error Indexes: mean 14.46 (SD 0.29) and 15.29 (SD 0.51), respectively. The Orthopaedic Error Index has enabled identification of hospitals that may be putting patients at disproportionate risk of orthopaedic-related iatrogenic harm and which therefore warrant further investigation. It provides the prototype of a summary index of harm to enable surveillance of unsafe care over time across institutions. Further validation and scrutiny of the method will be required to assess its potential to be extended to other hospital specialties in the UK and also internationally to other health systems that have comparable national databases of patient-safety incidents.

Burnout in Orthopaedic Surgeons: A Challenge for Leaders, Learners, and Colleagues: AOA Critical Issues.

Science.gov (United States)

Ames, S Elizabeth; Cowan, James B; Kenter, Keith; Emery, Sanford; Halsey, David

2017-07-19

Burnout, depression, suicidal ideation, and dissatisfaction with work-life balance have been reported in all medical specialties and at all stages of medical education and practice experience. Burnout consists of progressive emotional, attitudinal, and physical exhaustion. Physicians with burnout may treat patients as objects and feel emotionally depleted. Burnout is characterized by a loss of enthusiasm for work (emotional exhaustion), feelings of cynicism (depersonalization), and a low sense of personal accomplishment. The most complete study of emotional burnout among different medical specialties demonstrated that orthopaedic surgery is one of the specialties with the highest burnout rate. Qualitative descriptive studies are available. There was a 45.8% burnout rate among physicians in the U.S. in 2012, and a 2014 update suggested even higher rates. Burnout has a correlation with medical education. Burnout rates are similar to those in the general population when medical students enter school, and increase steadily through medical education prior to residency. Burnout rates in residents are high, reported to be between 41% and 74% across multiple specialties. This impacts our young physician workforce in orthopaedics. The purpose of this review is to provide the available information that characterizes burnout and addresses the issues inherent to preventing burnout, and to build awareness in orthopaedic surgeons. Wellness "goes beyond merely the absence of distress and includes being challenged, thriving, and achieving success in various aspects of personal and professional life." The challenge for the orthopaedic community is to develop interventions and strategies that are personalized to the individuals in this specialty.

SensorWeb Evolution Using the Earth Observing One (EO-1) Satellite as a Test Platform

Science.gov (United States)

Mandl, Daniel; Frye, Stuart; Cappelaere, Pat; Ly, Vuong; Handy, Matthew; Chien, Steve; Grossman, Robert; Tran, Daniel

2012-01-01

The Earth Observing One (EO-1) satellite was launched in November 2000 as a one year technology demonstration mission for a variety of space technologies. After the first year, in addition to collecting science data from its instruments, the EO-1 mission has been used as a testbed for a variety of technologies which provide various automation capabilities and which have been used as a pathfinder for the creation of SensorWebs. A SensorWeb is the integration of variety of space, airborne and ground sensors into a loosely coupled collaborative sensor system that automatically provides useful data products. Typically, a SensorWeb is comprised of heterogeneous sensors tied together with a messaging architecture and web services. This paper provides an overview of the various technologies that were tested and eventually folded into normal operations. As these technologies were folded in, the nature of operations transformed. The SensorWeb software enables easy connectivity for collaboration with sensors, but the side benefit is that it improved the EO-1 operational efficiency. This paper presents the various phases of EO-1 operation over the past 12 years and also presents operational efficiency gains demonstrated by some metrics.

EO system concepts in the littoral

Science.gov (United States)

Schwering, Piet B. W.; van den Broek, Sebastiaan P.; van Iersel, Miranda

2007-04-01

In recent years, operations executed by naval forces have taken place at many different locations. At present, operations against international terrorism and asymmetric warfare in coastal environments are of major concern. In these scenarios, the threat caused by pirates on-board of small surface targets, such as jetskis and fast inshore attack crafts, is increasing. In the littoral environment, the understanding of its complexity and the efficient use of the limited reaction time, are essential for successful operations. Present-day electro-optical sensor suites, also incorporating Infrared Search and Track systems, can be used for varying tasks as detection, classification and identification. By means of passive electro-optical systems, infrared and visible light sensors, improved situational awareness can be achieved. For long range capability, elevated sensor masts and flying platforms are ideally suited for the surveillance task and improve situational awareness. A primary issue is how to incorporate new electro-optical technology and signal processing into the new sensor concepts, to improve system performance. It is essential to derive accurate information from the high spatial-resolution imagery created by the EO sensors. As electro-optical sensors do not have all-weather capability, the performance degradation in adverse scenarios must be understood, in order to support the operational use of adaptive sensor management techniques. In this paper we discuss the approach taken at TNO in the design and assessment of system concepts for future IRST development. An overview of our maritime programme in future IRST and EO system concepts including signal processing is presented.

Do developmental orthopaedic disorders influence future jumping performances in Warmblood stallions?

DEFF Research Database (Denmark)

Verwilghen, Denis; Janssens, S; Busoni, V

2013-01-01

REASONS FOR PERFORMING THE STUDY: Few reports are available on the relationship between developmental orthopaedic diseases (DOD) and future performances in Warmblood horses. OBJECTIVES: To investigate the relationship between performance and the presence of DOD lesions. METHODS: Records of Warmbl...

Efficacy of Bobath versus orthopaedic approach on impairment and function at different motor recovery stages after stroke: a randomized controlled study.

Science.gov (United States)

Wang, Ray-Yau; Chen, Hsiu-I; Chen, Chen-Yin; Yang, Yea-Ru

2005-03-01

To investigate the effectiveness of Bobath on stroke patients at different motor stages by comparing their treatment with orthopaedic treatment. A single-blind study, with random assignment to Bobath or orthopaedic group. Physical therapy department of a medical centre. Twenty-one patients with stroke with spasticity and 23 patients with stroke at relative recovery stages participated. Twenty sessions of Bobath programme or orthopaedic treatment programme given in four weeks. Stroke Impairment Assessment Set (SIAS), Motor Assessment Scale (MAS), Berg Balance Scale (BBS) and Stroke Impact Scale (SIS) for impairment and functional limitation level. Participants with spasticity showed greater improvement in tone control (change score: 1.20 +/- 1.03 versus 0.08 +/- 0.67, p = 0.006), MAS (change score: 7.64 +/- 4.03 versus 4.00 +/- 1.95, p = 0.011), and SIS (change score: 7.30 +/- 6.24 versus 1.25 +/- 5.33, p = 0.023) after 20 sessions of Bobath treatment than with orthopaedic treatment. Participants with relative recovery receiving Bobath treatment showed greater improvement in MAS (change score: 6.14 +/- 5.55 versus 2.77 +/- 9.89, p = 0.007), BBS (change score: 19.18 +/- 15.94 versus 6.85 +/- 5.23, p = 0.015), and SIS scores (change score: 8.50 +/- 3.41 versus 3.62 +/- 4.07, p = 0.006) than those with orthopaedic treatment. Bobath or orthopaedic treatment paired with spontaneous recovery resulted in improvements in impairment and functional levels for patient with stroke. Patients benefit more from the Bobath treatment in MAS and SIS scores than from the orthopaedic treatment programme regardless of their motor recovery stages.

Trend report Energy Research Subsidy programme (2005-2008). A report on the most important trends and effects since the start of the Energy Research Subsidy (EOS) programme

International Nuclear Information System (INIS)

Kimman, J.; Soeriowardojo, E.; Witte, F.; Nijdam, J.

2009-07-01

In 2005 the Energy Research Subsidy programme (EOS) was launched in the Netherlands. In four years' time about 500 projects were realized thanks to contributions from EOS. This report provides an overview of the main trends and effects of EOS in the period 2005-2008. One of the main conclusions is that a number of technologies have developed from invention level to market-ready level thanks to the EOS programme. The main trends since the start of EOS are: Increasing confidence of investors in EOS spearheads; increasing activity in EOS spearheads; Spearheads shifting to investment and exploitation schemes; EOS contributes to a solid patent position of Dutch parties; EOS contributes to European research. [nl

Biocompatibility of orthopaedic implants on bone forming cells

OpenAIRE

Kapanen, A. (Anita)

2002-01-01

Abstract Reindeer antler was studied for its possible use as a bone implant material. A molecular biological study showed that antler contains a growth factor promoting bone formation. Ectopic bone formation assay showed that antler is not an equally effective inducer as allogenic material. Ectopic bone formation assay was optimised for biocompatibility studies of orthopaedic NiTi implants. Ti-6Al-4V and stainless steel were used as reference materials. The assay...

The EOS and neutrino interactions in dense matter

Energy Technology Data Exchange (ETDEWEB)

Prakash, M; Reddy, S [Dept. of Physics and Astronomy, SUNY at Stony Brook, Stony Brook, NY (United States)

1998-06-01

The deleptonization and cooling times of a newly born neutron star depend on the equation of state (EOS) and neutrino opacities in dense matter. Through model calculations we show that effects of Pauli blocking and many-body correlations due to strong interactions reduce both the neutral and charged current neutrino cross sections by large factors compared to the case in which these effects are ignored. (orig.)

A Collaboration in Support of LBA Science and Data Exchange: Beija-flor and EOS-WEBSTER

Science.gov (United States)

Schloss, A. L.; Gentry, M. J.; Keller, M.; Rhyne, T.; Moore, B.

2001-12-01

The University of New Hampshire (UNH) has developed a Web-based tool that makes data, information, products, and services concerning terrestrial ecological and hydrological processes available to the Earth Science community. Our WEB-based System for Terrestrial Ecosystem Research (EOS-WEBSTER) provides a GIS-oriented interface to select, subset, reformat and download three main types of data: selected NASA Earth Observing System (EOS) remotely sensed data products, results from a suite of ecosystem and hydrological models, and geographic reference data. The Large Scale Biosphere-Atmosphere Experiment in Amazonia Project (LBA) has implemented a search engine, Beija-flor, that provides a centralized access point to data sets acquired for and produced by LBA researchers. The metadata in the Beija-flor index describe the content of the data sets and contain links to data distributed around the world. The query system returns a list of data sets that meet the search criteria of the user. A common problem when a user of a system like Beija-flor wants data products located within another system is that users are required to re-specify information, such as spatial coordinates, in the other system. This poster describes methodology by which Beija-flor generates a unique URL containing the requested search parameters and passes the information to EOS-WEBSTER, thus making the interactive services and large diverse data holdings in EOS-WEBSTER directly available to Beija-flor users. This "Calling Card" is used by EOS-WEBSTER to generate on-demand custom products tailored to each Beija-flor request. Through a collaborative effort, we have demonstrated the ability to integrate project-specific search engines such as Beija-flor with the products and services of large data systems such as EOS-WEBSTER, to provide very specific information products with a minimal amount of additional programming. This methodology has the potential to greatly facilitate research data exchange by

An international survey to identify the intrinsic and extrinsic factors of research studies most likely to change orthopaedic practice.

Science.gov (United States)

Thornley, P; de Sa, D; Evaniew, N; Farrokhyar, F; Bhandari, M; Ghert, M

2016-04-01

Evidence -based medicine (EBM) is designed to inform clinical decision-making within all medical specialties, including orthopaedic surgery. We recently published a pilot survey of the Canadian Orthopaedic Association (COA) membership and demonstrated that the adoption of EBM principles is variable among Canadian orthopaedic surgeons. The objective of this study was to conduct a broader international survey of orthopaedic surgeons to identify characteristics of research studies perceived as being most influential in informing clinical decision-making. A 29-question electronic survey was distributed to the readership of an established orthopaedic journal with international readership. The survey aimed to analyse the influence of both extrinsic (journal quality, investigator profiles, etc.) and intrinsic characteristics (study design, sample size, etc.) of research studies in relation to their influence on practice patterns. A total of 353 surgeons completed the survey. Surgeons achieved consensus on the 'importance' of three key designs on their practices: randomised controlled trials (94%), meta-analyses (75%) and systematic reviews (66%). The vast majority of respondents support the use of current evidence over historical clinical training; however subjective factors such as journal reputation (72%) and investigator profile (68%) continue to influence clinical decision-making strongly. Although intrinsic factors such as study design and sample size have some influence on clinical decision-making, surgeon respondents are equally influenced by extrinsic factors such as investigator reputation and perceived journal quality.Cite this article: Dr M. Ghert. An international survey to identify the intrinsic and extrinsic factors of research studies most likely to change orthopaedic practice. Bone Joint Res 2016;5:130-136. DOI: 10.1302/2046-3758.54.2000578. © 2016 Ghert et al.

Cinnamon Oil and Chitosan Coating on Orthopaedic Implant Surface for Prevention of Staphylococcus Epidermidis Biofilm Formation

OpenAIRE

R Magetsari; P Dewo; BK Saputro; Z Lanodiyu

2014-01-01

S. Epidermidis is among the most frequently isolated microorganisms found in -infection related to implanted devices and the formation of biofilm will be more resistantcompared to the planktonic form. This study was carried out determine the effect of coating on stainless steel orthopaedic implants surfaces with cinnamon oil and chitosan as bioadhesive to prevent biofilms formation of S. Epidermidis.The rod shaped stainless steel 316 L orthopaedic implant with 5 mm diameters was coated 2 t...

The role of serial casting in early-onset scoliosis (EOS).

Science.gov (United States)

Baulesh, David M; Huh, Jeannie; Judkins, Timothy; Garg, Sumeet; Miller, Nancy H; Erickson, Mark A

2012-01-01

Serial casting has demonstrated efficacy for idiopathic early-onset scoliosis (EOS). Results of casting in nonidiopathic (syndromic and congenital) EOS patients have not previously been well described. A total of 53 patients underwent serial casting for EOS from 2005 to 2010 at a single institution. Deformity was classified as idiopathic or nonidiopathic. Diagnosis, time in cast, number of casts, use of bracing, complications, and outcomes were recorded. Radiographic measures included Cobb angle and thoracic height (T1-T12). Thoracic height velocity was calculated and compared with established norms. A total of 36 patients, 19 idiopathic and 17 nonidiopathic (14 syndromic, 3 congenital), completed cast treatment and had >6-month follow-up and were therefore included. Of those, 17% (6/36) experienced resolution of their deformity, 53% (19/26) are currently in braces, and 31% (11/36) had undergone surgery. Surgery occurred on average at age 5.6 years and was delayed by an average of 2.1 years from time of first cast. A 19% complication was observed. There was no statistical difference in the rate of resolution of deformity between idiopathic (5/19) and nonidiopathic (1/17) patients (P=0.182), although there exists a trend toward greater curve correction in idiopathic patients. Surgery occurred in fewer patients (2/19) in the idiopathic group compared with the nonidiopathic group (9/17) (P=0.006). Significant improvements in Cobb angle was observed in the idiopathic group (12.2 degrees) during casting (P=0.003). Nonidiopathic patients did not maintain the correction gained during casting at the time of final follow-up. T1-T12 height increased across all study patients regardless of etiology during the period of casting at similar velocity to established norms of 1.4 cm/y for this age group. Serial casting offers modest deformity correction in idiopathic deformities compared with nonidiopathic deformities. Thoracic height growth continued throughout the casting period

Haemodilution study in major orthopaedic surgery experience as a technique of blood conservation.

Science.gov (United States)

Liaw, Y; Boon, P; Deshpande, S

1994-08-01

Haemodilution and auto-transfusion were carried out in 103 consecutive patients having major orthopaedic surgery. The records of 99 patients were available for retrospective assessment of this technique. Fifty-six per cent of the patients did not require any homologous blood transfusion. Homologous blood transfusion was given to 44% of the patients, who used up 99 units of blood in their entire hospital stay. There was no morbidity such as transfusion reaction, infection, decrease in platelets or re-operation for bleeding associated with the procedure, although there was one death secondary to myocardial infarction. This technique offered an alternative method to reduce the use of homologous blood transfusion in major orthopaedic operations.

Nanostructured diamond coatings for orthopaedic applications

Science.gov (United States)

CATLEDGE, S.A.; THOMAS, V.; VOHRA, Y.K.

2013-01-01

With increasing numbers of orthopaedic devices being implanted, greater emphasis is being placed on ceramic coating technology to reduce friction and wear in mating total joint replacement components, in order to improve implant function and increase device lifespan. In this chapter, we consider ultra-hard carbon coatings, with emphasis on nanostructured diamond, as alternative bearing surfaces for metallic components. Such coatings have great potential for use in biomedical implants as a result of their extreme hardness, wear resistance, low friction and biocompatibility. These ultra-hard carbon coatings can be deposited by several techniques resulting in a wide variety of structures and properties. PMID:25285213

[Clinical safety and professional liability claims in Orthopaedic Surgery and Traumatology].

Science.gov (United States)

Bori, G; Gómez-Durán, E L; Combalia, A; Trilla, A; Prat, A; Bruguera, M; Arimany-Manso, J

2016-01-01

The specialist in orthopaedic and traumatological surgery, like any other doctor, is subject to the current legal provisions while exercising their profession. Mandatory training in the medical-legal aspects of health care is essential. Claims against doctors are a reality, and orthopaedic and traumatological surgery holds first place in terms of frequency of claims according to the data from the General Council of Official Colleges of Doctors of Catalonia. Professionals must be aware of the fundamental aspects of medical professional liability, as well as specific aspects, such as defensive medicine and clinical safety. The understanding of these medical-legal aspects in the routine clinical practice can help to pave the way towards a satisfactory and safe professional career. The aim of this review is to contribute to this training, for the benefit of professionals and patients. Copyright © 2015 SECOT. Published by Elsevier Espana. All rights reserved.

Barriers and strategies for the clinical translation of advanced orthopaedic tissue engineering protocols.

Science.gov (United States)

Madry, H; Alini, M; Stoddart, M J; Evans, C; Miclau, T; Steiner, S

2014-05-06

Research in orthopaedic tissue engineering has intensified over the last decade and new protocols continue to emerge. The clinical translation of these new applications, however, remains associated with a number of obstacles. This report highlights the major issues that impede the clinical translation of advanced tissue engineering concepts, discusses strategies to overcome these barriers, and examines the need to increase incentives for translational strategies. The statements are based on presentations and discussions held at the AO Foundation-sponsored symposium "Where Science meets Clinics 2013" held at the Congress Center in Davos, Switzerland, in September, 2013. The event organisers convened a diverse group of over one hundred stakeholders involved in clinical translation of orthopaedic tissue engineering, including scientists, clinicians, healthcare industry professionals and regulatory agency representatives. A major point that emerged from the discussions was that there continues to be a critical need for early trans-disciplinary communication and collaboration in the development and execution of research approaches. Equally importantly was the need to address the shortage of sustained funding programs for multidisciplinary teams conducting translational research. Such detailed discussions between experts contribute towards the development of a roadmap to more successfully advance the clinical translation of novel tissue engineering concepts and ultimately improve patient care in orthopaedic and trauma surgery.

Barriers and strategies for the clinical translation of advanced orthopaedic tissue engineering protocols

Directory of Open Access Journals (Sweden)

H Madry

2014-05-01

Full Text Available Research in orthopaedic tissue engineering has intensified over the last decade and new protocols continue to emerge. The clinical translation of these new applications, however, remains associated with a number of obstacles. This report highlights the major issues that impede the clinical translation of advanced tissue engineering concepts, discusses strategies to overcome these barriers, and examines the need to increase incentives for translational strategies. The statements are based on presentations and discussions held at the AO Foundation-sponsored symposium "Where Science meets Clinics 2013" held at the Congress Center in Davos, Switzerland, in September, 2013. The event organisers convened a diverse group of over one hundred stakeholders involved in clinical translation of orthopaedic tissue engineering, including scientists, clinicians, healthcare industry professionals and regulatory agency representatives. A major point that emerged from the discussions was that there continues to be a critical need for early trans-disciplinary communication and collaboration in the development and execution of research approaches. Equally importantly was the need to address the shortage of sustained funding programs for multidisciplinary teams conducting translational research. Such detailed discussions between experts contribute towards the development of a roadmap to more successfully advance the clinical translation of novel tissue engineering concepts and ultimately improve patient care in orthopaedic and trauma surgery.

EOS MLS Level 1B Data Processing Software. Version 3

Science.gov (United States)

Perun, Vincent S.; Jarnot, Robert F.; Wagner, Paul A.; Cofield, Richard E., IV; Nguyen, Honghanh T.; Vuu, Christina

2011-01-01

This software is an improvement on Version 2, which was described in EOS MLS Level 1B Data Processing, Version 2.2, NASA Tech Briefs, Vol. 33, No. 5 (May 2009), p. 34. It accepts the EOS MLS Level 0 science/engineering data, and the EOS Aura spacecraft ephemeris/attitude data, and produces calibrated instrument radiances and associated engineering and diagnostic data. This version makes the code more robust, improves calibration, provides more diagnostics outputs, defines the Galactic core more finely, and fixes the equator crossing. The Level 1 processing software manages several different tasks. It qualifies each data quantity using instrument configuration and checksum data, as well as data transmission quality flags. Statistical tests are applied for data quality and reasonableness. The instrument engineering data (e.g., voltages, currents, temperatures, and encoder angles) is calibrated by the software, and the filter channel space reference measurements are interpolated onto the times of each limb measurement with the interpolates being differenced from the measurements. Filter channel calibration target measurements are interpolated onto the times of each limb measurement, and are used to compute radiometric gain. The total signal power is determined and analyzed by each digital autocorrelator spectrometer (DACS) during each data integration. The software converts each DACS data integration from an autocorrelation measurement in the time domain into a spectral measurement in the frequency domain, and estimates separately the spectrally, smoothly varying and spectrally averaged components of the limb port signal arising from antenna emission and scattering effects. Limb radiances are also calibrated.

Evaluation of software based redundancy algorithms for the EOS storage system at CERN

International Nuclear Information System (INIS)

Peters, Andreas-Joachim; Sindrilaru, Elvin Alin; Zigann, Philipp

2012-01-01

EOS is a new disk based storage system used in production at CERN since autumn 2011. It is implemented using the plug-in architecture of the XRootD software framework and allows remote file access via XRootD protocol or POSIX-like file access via FUSE mounting. EOS was designed to fulfill specific requirements of disk storage scalability and IO scheduling performance for LHC analysis use cases. This is achieved by following a strategy of decoupling disk and tape storage as individual storage systems. A key point of the EOS design is to provide high availability and redundancy of files via a software implementation which uses disk-only storage systems without hardware RAID arrays. All this is aimed at reducing the overall cost of the system and also simplifying the operational procedures. This paper presents the advantages and disadvantages of redundancy by hardware (most classical storage installations) in comparison to redundancy by software. The latter is implemented in the EOS system and achieves its goal by spawning data and parity stripes via remote file access over nodes. The gain in redundancy and reliability comes with a trade-off in the following areas: • Increased complexity of the network connectivity • CPU intensive parity computations during file creation and recovery • Performance loss through remote disk coupling An evaluation and performance figures of several redundancy algorithms are presented for dual parity RAID and Reed-Solomon codecs. Moreover, the characteristics and applicability of these algorithms are discussed in the context of reliable data storage systems.

Direct cellular vs. indirect pager communication during orthopaedic surgical procedures: a prospective study.

Science.gov (United States)

Ortega, Gil R; Taksali, Sudeep; Smart, Ryan; Baumgaertner, Michael R

2009-01-01

Cellular phone use within the hospital setting has increased as physicians, nurses, and ancillary staff incorporate wireless technologies in improving efficiencies, cost, and maintaining patient safety and high quality healthcare [11]. Through the use of wireless, cellular communication, an overall improvement in communication accuracy and efficiency between intraoperative orthopaedic surgeons and floor nurses may be achieved. Both communication types occurred while the surgeon was scrubbed in the operating room (OR). Indirect communication occurred when the pager call was answered by the OR circulating nurse with communication between the surgeon, circulating nurse, and floor nurse. Direct communication consisted of cell phone and Jabra Bluetooth BT200 wireless ear piece used by the surgeon. The surgeon answered the floor nurse's cellular call by phone ring-activated automatic answering. The study was conducted during scheduled orthopaedic procedures. An independent observer measured time variables with a stop-watch while orthopaedic nurses randomly called via pager or cell phone. The nurses asked for patient caregiver confirmation and answers to 30 different patient-care questions. Sixty trials were performed with 30 cell and 30 page communications. Direct cellular communication showed a better response rate than indirect page (Cell 100%, Page 73%). Indirect page communication allowed a 27% and 33% error rate with patient problem and surgeon solution communications, respectively. There were no reported communication errors while using direct wireless, cellular communication. When compared to page communications, cellular communications showed statistically significant improvements in mean time intervals in response time (Cell = 11s, Page = 211s), correct patient identification (Cell = 5s, Page = 172s), patient problem and solution time (Cell = 13s, Page = 189s), and total communication time (Cell = 32s, Page = 250s) (s = seconds, all P < 0.001). Floor nurse

Strategic planning in a highly specialized orthopaedic institution

Directory of Open Access Journals (Sweden)

Vukašinović Zoran

2009-01-01

Full Text Available Introduction. The Institute for Orthopaedic Surgery 'Banjica' in Belgrade provides tertiary healthcare services on national level. After decades of constant development, a recent decline coincided with the decade of great social and governmental disturbance, the transition period after the dissociation of former Yugoslavia. Objective. In order to overcome the crisis, we used modern management methods to define problems in the institution management, and to propose appropriate strategies. Methods. A survey that included 100 employees (17.67% was carried out, followed by descriptive statistical analysis, PEST and SWOT analyses. Results The impact of political fluctuations, ageing of population, financing model, obsolete medical technology was evaluated. Various personal and interpersonal factors were assessed: the quality of medical service (3.59±0.76, mark 1-5; relations among health service participants (3.39±0.78; occupational conditions (not good-91%; human, financial and other resources; professional cooperation, stimulation; rivalry and mobbing (declared in 56%; public informing, institution image (rank 3.70±0.88 and PR activities (new to 78%. 93% declared to give maximum effort at work. Conclusion. Using these results, we defined several strategic objectives. These include strengthening scientific activities, general orientation to specific and exclusive pathological conditions and treatment methods, improvement of management transparency, introduction of quality-based stimulation of workers, support of promotional and PR activities.

[The Summer School of the German Society for Orthopaedics and Traumatology - A Success Story].

Science.gov (United States)

Merschin, D; Mutschler, M; Stange, R; Kopschina, C; Schüttrumpf, J P; Doepfer, A K; Achatz, G; Niethard, M; Hoffmann, R; Kladny, B; Perl, M; Münzberg, M

2016-10-01

Background: It has been known for several years that orthopaedic and trauma clinics suffer from a shortage of young people, due to the substantial loss in attractiveness. The Youth Forum OU has been addressing this problem for many years, by initiating many projects such as the Summer School to counteract this trend. The purpose of this research is to evaluate the success of Summer Schools since 2009. Methods: The Youth Forum OU performed a survey in December 2014 to answer the research question on the basis of an internet-based poll of the student participants in all Summer Schools between 2009 and 2014. Following data cleansing, 121 students and former students were included in the survey. Results: Seventy-two completed questionnaires were collected and included in the evaluation. The survey included 40 % of Summer School participants, with a mean age of 27.3 years (SD ± 2.95); 50 % were female. Participation in the Summer School helped 50 % of the respondents to decide to start advanced study in orthopaedics and/or traumatology (OU). One third of these Summer School participants had already finished a university degree; 100 % are now residents in orthopaedics and/or traumatology. Regardless of prior plans, 87.2 % of participants are now residents in OU. Thirty-three are still students: 78.8 % have already decided to work in OU. The survey also served to identify the factors positively and negatively associated with OU. Unfavourable factors included the reputation of OU, and the difficulty of reconciling family and work. Favourable factors included surgical work and personal experience during university studies. Discussion: The aim of this study was to evaluate whether the efforts of the Youth Forum OU, the German Society for Orthopaedics and Traumatology (DGOU) and the local hospitals lead to increased interest in OU. The answer to this question is positive. This is particularly true for those students who did not plan to become an orthopaedic or

Surgical skills simulation in trauma and orthopaedic training

OpenAIRE

Stirling, Euan RB; Lewis, Thomas L; Ferran, Nicholas A

2014-01-01

Changing patterns of health care delivery and the rapid evolution of orthopaedic surgical techniques have made it increasingly difficult for trainees to develop expertise in their craft. Working hour restrictions and a drive towards senior led care demands that proficiency be gained in a shorter period of time whilst requiring a greater skill set than that in the past. The resulting conflict between service provision and training has necessitated the development of alternative methods in orde...

Studies on EOS of shock-generated argon plasmas

International Nuclear Information System (INIS)

Wang Fanhou; Jing Fuqian

2001-01-01

The equation of state for argon plasma, covering the thermodynamic states of 10000-30000 K in temperature and 0.0133-0.166 GPa in pressure, is computed using the Saha model and Debye-Huckel correction. Comparisons of the measured EOS with the calculated ones demonstrate the Saha model and Debye-Huckel correction can be used to well describe the essential behavior of argon plasma under the thermodynamic condition above-mentioned

Treating natural disaster victims is dealing with shortages: An orthopaedics perspective.

NARCIS (Netherlands)

Dewo, Punto; Magetsari, Rahadyan; Busscher, Henk J.; van Horn, Jim R.; Verkerke, Gijsbertus Jacob

2008-01-01

During natural disasters such as earthquakes or tsunamis, most of the casualties are known to suffer from musculoskeletal injuries. This leads to an enormous need of orthopaedic (surgical) implants such as osteosynthesis plates, which are difficult to provide in developing countries that rely on

Adverse Effects of Smoking on Outcomes of Orthopaedic Surgery

OpenAIRE

Sheung-tung Ho

2017-01-01

Smoking has many adverse effects on the musculoskeletal system, particularly on the outcomes after orthopaedic surgery. Smoking is associated with surgical site infection and postoperative wound complications after spine surgery, total joint arthroplasty, and fracture fixation; nonunion after spinal fusion, ankle fusion, osteotomy, and internal fixation and bone grafting for scaphoid nonunion; worse outcomes after lumbar disc prolapse, spinal stenosis, and cervical myelopathy surgery; peripro...

Mesoscopic Simulations of the Phase Behavior of Aqueous EO 19 PO 29 EO 19 Solutions Confined and Sheared by Hydrophobic and Hydrophilic Surfaces

KAUST Repository

Liu, Hongyi

2012-01-25

The MesoDyn method is used to investigate associative structures in aqueous solution of a nonionic triblock copolymer consisting of poly(propylene oxide) capped on both ends with poly(ethylene oxide) chains. The effect of adsorbing (hydrophobic) and nonadsorbing (hydrophilic) solid surfaces in contact with aqueous solutions of the polymer is elucidated. The macromolecules form self-assembled structures in solution. Confinement under shear forces is investigated in terms of interfacial behavior and association. The formation of micelles under confinement between hydrophilic surfaces occurs faster than in bulk aqueous solution while layered structures assemble when the polymers are confined between hydrophobic surfaces. Micelles are deformed under shear rates of 1 μs -1 and eventually break to form persistent, adsorbed layered structures. As a result, surface damage under frictional forces is prevented. Overall, this study indicates that aqueous triblock copolymers of poly(ethylene oxide) (PEO) and poly(propylene oxide) (PPO) (Pluronics, EO mPO nEO m) act as a boundary lubricant for hydrophobic surfaces but not for hydrophilic ones. © 2011 American Chemical Society.

Mesoscopic Simulations of the Phase Behavior of Aqueous EO 19 PO 29 EO 19 Solutions Confined and Sheared by Hydrophobic and Hydrophilic Surfaces

KAUST Repository

Liu, Hongyi; Li, Yan; Krause, Wendy E.; Pasquinelli, Melissa A.; Rojas, Orlando J.

2012-01-01

The MesoDyn method is used to investigate associative structures in aqueous solution of a nonionic triblock copolymer consisting of poly(propylene oxide) capped on both ends with poly(ethylene oxide) chains. The effect of adsorbing (hydrophobic) and nonadsorbing (hydrophilic) solid surfaces in contact with aqueous solutions of the polymer is elucidated. The macromolecules form self-assembled structures in solution. Confinement under shear forces is investigated in terms of interfacial behavior and association. The formation of micelles under confinement between hydrophilic surfaces occurs faster than in bulk aqueous solution while layered structures assemble when the polymers are confined between hydrophobic surfaces. Micelles are deformed under shear rates of 1 μs -1 and eventually break to form persistent, adsorbed layered structures. As a result, surface damage under frictional forces is prevented. Overall, this study indicates that aqueous triblock copolymers of poly(ethylene oxide) (PEO) and poly(propylene oxide) (PPO) (Pluronics, EO mPO nEO m) act as a boundary lubricant for hydrophobic surfaces but not for hydrophilic ones. © 2011 American Chemical Society.

Share Your Opinion With Other Eos Readers

Science.gov (United States)

Narasimhan, T. N.

2006-11-01

Earlier this year, Robert Kitchen (Eos, 87(24), 235, 2006) drew attention to declining interest in Earth science education in public schools. The reason for a lack of interest in teaching Earth sciences in public schools may involve more than just the attitudes of parents who may wish for their children a better preparation for advanced placement courses later on. Part of the problem may lie with our present mind-set that technology can solve all the world's problems, from poverty, to better health, and to prosperity.

Three-dimensional assessment of the intervertebral kinematics after Mobi-C total disc replacement at the cervical spine in vivo using the EOS stereoradiography system.

Science.gov (United States)

Rousseau, Marc-Antoine; Laporte, Sébastien; Dufour, Thierry; Steib, Jean-Paul; Lazennec, Jean-Yves; Skalli, Wafa

2011-01-01

Because 3-dimensional computed tomography and magnetic resonance imaging analysis of the spinal architecture is done with the patient in the supine position, stereoradiography may be more clinically relevant for the measurement of the relative displacements of the cervical vertebrae in vivo in the upright position. The innovative EOS stereoradiography system was used for measuring the relative angular displacements of the cervical vertebrae in a limited population to determine its feasibility. The precision and accuracy of the method were investigated. In 9 patients with 16 Mobi-C prostheses (LDR Medical, Troyes, France) and 12 healthy subjects, EOS stereoradiography of the lower cervical spine (C3-7) was performed in the neutral upright position of the neck, flexion, extension, left and right lateral bending, and left and right axial rotation. The angular displacements were measured from the neutral position to every other posture. The random error was studied in terms of reproducibility. In addition, an in vitro protocol was performed in 6 specimens to investigate accuracy. The reproducibility and the accuracy variables varied similarly between 1.2° and 3.2° depending on the axis and direction of rotation under consideration. The Mobi-C group showed less mobility than the control group, whereas the pattern of coupling was similar. Overall, the feasibility of dynamic EOS stereoradiography was shown. The prosthesis replicates the pattern of motion of the normal cervical spine.

Readability of Orthopaedic Patient-reported Outcome Measures: Is There a Fundamental Failure to Communicate?

Science.gov (United States)

Perez, Jorge L; Mosher, Zachary A; Watson, Shawna L; Sheppard, Evan D; Brabston, Eugene W; McGwin, Gerald; Ponce, Brent A

2017-08-01

Patient-reported outcome measures (PROMs) are increasingly used to quantify patients' perceptions of functional ability. The American Medical Association and NIH suggest patient materials be written at or below 6th to 8th grade reading levels, respectively, yet one recent study asserts that few PROMs comply with these recommendations, and suggests that the majority of PROMs are written at too high of a reading level for self-administered patient use. Notably, this study was limited in its use of only one readability algorithm, although there is no commonly accepted, standard readability algorithm for healthcare-related materials. Our study, using multiple readability equations and heeding equal weight to each, hopes to yield a broader, all-encompassing estimate of readability, thereby offering a more accurate assessment of the readability of orthopaedic PROMS. (1) What proportion of orthopaedic-related PROMs and orthopaedic-related portions of the NIH Patient Reported Outcomes Measurement Information System (PROMIS ® ) are written at or below the 6th and 8th grade levels? (2) Is there a correlation between the number of questions in the PROM and reading level? (3) Using systematic edits based on guidelines from the Centers for Medicare and Medicaid Services, what proportion of PROMs achieved American Medical Association and NIH-recommended reading levels? Eighty-six (86) independent, orthopaedic and general wellness PROMs, drawn from commonly referenced orthopaedic websites and prior studies, were chosen for analysis. Additionally, owing to their increasing use in orthopaedics, four relevant short forms, and 11 adult, physical health question banks from the PROMIS ® , were included for analysis. All documents were analyzed for reading grade levels using 19 unique readability algorithms. Descriptive statistics were performed using SPSS Version 22.0. The majority of the independent PROMs (64 of 86; 74%) were written at or below the 6th grade level, with 81 of 86

76 FR 47527 - Retrospective Regulatory Review Under E.O. 13563

Science.gov (United States)

2011-08-05

... DEPARTMENT OF COMMERCE Bureau of Industry and Security 15 CFR Chapter VII [Docket No. 110711380-1379-01] RIN 0694-XA37 Retrospective Regulatory Review Under E.O. 13563 AGENCY: Bureau of Industry and Security, Commerce. ACTION: Notice of inquiry. SUMMARY: The Bureau of Industry and Security (BIS...

Comparison of multiple linear regression and artificial neural network in developing the objective functions of the orthopaedic screws.

Science.gov (United States)

Hsu, Ching-Chi; Lin, Jinn; Chao, Ching-Kong

2011-12-01

Optimizing the orthopaedic screws can greatly improve their biomechanical performances. However, a methodical design optimization approach requires a long time to search the best design. Thus, the surrogate objective functions of the orthopaedic screws should be accurately developed. To our knowledge, there is no study to evaluate the strengths and limitations of the surrogate methods in developing the objective functions of the orthopaedic screws. Three-dimensional finite element models for both the tibial locking screws and the spinal pedicle screws were constructed and analyzed. Then, the learning data were prepared according to the arrangement of the Taguchi orthogonal array, and the verification data were selected with use of a randomized selection. Finally, the surrogate objective functions were developed by using either the multiple linear regression or the artificial neural network. The applicability and accuracy of those surrogate methods were evaluated and discussed. The multiple linear regression method could successfully construct the objective function of the tibial locking screws, but it failed to develop the objective function of the spinal pedicle screws. The artificial neural network method showed a greater capacity of prediction in developing the objective functions for the tibial locking screws and the spinal pedicle screws than the multiple linear regression method. The artificial neural network method may be a useful option for developing the objective functions of the orthopaedic screws with a greater structural complexity. The surrogate objective functions of the orthopaedic screws could effectively decrease the time and effort required for the design optimization process. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Expanding NASA's Land, Atmosphere Near real-time Capability for EOS

Science.gov (United States)

Davies, D.; Michael, K.; Masuoka, E.; Ye, G.; Schmaltz, J. E.; Harrison, S.; Ziskin, D.; Durbin, P. B.; Protack, S.; Rinsland, P. L.; Slayback, D. A.; Policelli, F. S.; Olsina, O.; Fu, G.; Ederer, G. A.; Ding, F.; Braun, J.; Gumley, L.; Prins, E. M.; Davidson, C. C.; Wong, M. M.

2017-12-01

NASA's Land, Atmosphere Near real-time Capability for EOS (LANCE) is a virtual system that provides near real-time EOS data and imagery to meet the needs of scientists and application users interested in monitoring a wide variety of natural and man-made phenomena in near real-time. Over the last year: near real-time products and imagery from MOPITT, MISR, OMPS and VIIRS (Land and Atmosphere) have been added; the Fire Information for Resource Management System (FIRMS) has been updated and LANCE has begun the process of integrating the Global NRT flood product. In addition, following the AMSU-A2 instrument anomaly in September 2016, AIRS-only products have replaced the NRT level 2 AIRS+AMSU products. This presentation provides a brief overview of LANCE, describes the new products that are recently available and contains a preview of what to expect in LANCE over the coming year. For more information visit: https://earthdata.nasa.gov/lance

A low-cost transportable ground station for capture and processing of direct broadcast EOS satellite data

Science.gov (United States)

Davis, Don; Bennett, Toby; Short, Nicholas M., Jr.

1994-01-01

The Earth Observing System (EOS), part of a cohesive national effort to study global change, will deploy a constellation of remote sensing spacecraft over a 15 year period. Science data from the EOS spacecraft will be processed and made available to a large community of earth scientists via NASA institutional facilities. A number of these spacecraft are also providing an additional interface to broadcast data directly to users. Direct broadcast of real-time science data from overhead spacecraft has valuable applications including validation of field measurements, planning science campaigns, and science and engineering education. The success and usefulness of EOS direct broadcast depends largely on the end-user cost of receiving the data. To extend this capability to the largest possible user base, the cost of receiving ground stations must be as low as possible. To achieve this goal, NASA Goddard Space Flight Center is developing a prototype low-cost transportable ground station for EOS direct broadcast data based on Very Large Scale Integration (VLSI) components and pipelined, multiprocessing architectures. The targeted reproduction cost of this system is less than $200K. This paper describes a prototype ground station and its constituent components.

Addressing EO-1 Spacecraft Pulsed Plasma Thruster EMI Concerns

Science.gov (United States)

Zakrzwski, C. M.; Davis, Mitch; Sarmiento, Charles; Bauer, Frank H. (Technical Monitor)

2001-01-01

The Pulsed Plasma Thruster (PPT) Experiment on the Earth Observing One (EO-1) spacecraft has been designed to demonstrate the capability of a new generation PPT to perform spacecraft attitude control. Results from PPT unit level radiated electromagnetic interference (EMI) tests led to concerns about potential interference problems with other spacecraft subsystems. Initial plans to address these concerns included firing the PPT at the spacecraft level both in atmosphere, with special ground support equipment. and in vacuum. During the spacecraft level tests, additional concerns where raised about potential harm to the Advanced Land Imager (ALI). The inadequacy of standard radiated emission test protocol to address pulsed electromagnetic discharges and the lack of resources required to perform compatibility tests between the PPT and an ALI test unit led to changes in the spacecraft level validation plan. An EMI shield box for the PPT was constructed and validated for spacecraft level ambient testing. Spacecraft level vacuum tests of the PPT were deleted. Implementation of the shield box allowed for successful spacecraft level testing of the PPT while eliminating any risk to the ALI. The ALI demonstration will precede the PPT demonstration to eliminate any possible risk of damage of ALI from PPT operation.

Antimicrobial and Osseointegration Properties of Nanostructured Titanium Orthopaedic Implants

OpenAIRE

Jäger, Marcus; Jennissen, Herbert P.; Dittrich, Florian; Fischer, Alfons; Köhling, Hedda Luise

2017-01-01

The surface design of titanium implants influences not only the local biological reactions but also affects at least the clinical result in orthopaedic application. During the last decades, strong efforts have been made to improve osteointegration and prevent bacterial adhesion to these surfaces. Following the rule of “smaller, faster, cheaper”, nanotechnology has encountered clinical application. It is evident that the hierarchical implant surface micro- and nanotopography orchestrate the bi...

Optimized collection of EoL electronic products for Circular economy: A techno-economic assessment

DEFF Research Database (Denmark)

Angouria-Tsorochidou, Elisavet; Cimpan, Ciprian; Parajuly, Keshav

2018-01-01

The relevance of a circular model is widely accepted for the lifecycle management of electrical and electronic products (e-products), given the low recovery rates of valuable resources in current end-of-life (EoL) practices focused on recycling. However, missing insight into the technical...... and business potential for alternative EoL options (reuse, repair and remanufacturing) holds stakeholders from implementing circular strategies. In this context, our study first mapped by means of material flow analysis (MFA) the life cycle stages of e-products in Denmark and then performed a preliminary...

The influence of alcohol and tobacco use in orthopaedic inpatients on complications of surgery.

Science.gov (United States)

Williams, Gerard; Daly, Michelle; Proude, Elizabeth M; Kermode, Steven; Davis, Michelle; Barling, Jan; Haber, Paul S

2008-01-01

Tobacco use and heavy alcohol consumption are associated with increased morbidity and mortality. There is limited research on the correlation between tobacco and risky levels of alcohol use and the possible complications associated with a hospital admission. The underestimation of problem drinking, in particular, has obvious repercussions for the management of patients in hospital. If alcohol-related problems go undetected or unrecorded, treatment may be inadequate or inappropriate. The aims of the project were to assess the prevalence of high-risk alcohol and tobacco use in orthopaedic in-patients and to examine any relationship between alcohol and tobacco use and the number and type of complications, management and length of stay. One hundred and fifty-three consecutive orthopaedic admissions to the Orthopaedic Ward at Lismore Base Hospital were screened using the Drinkcheck questionnaire, which is based on the Alcohol Use Disorders Identification Test (AUDIT), but which also screens for tobacco use. Nursing staff on the ward completed a Complications Evaluation Questionnaire (CEQ). The risk status of the subjects was compared to the number and type of complications, to assess any effects of alcohol and tobacco on post-surgical complications. Significant correlations were found between tobacco use, hazardous and harmful alcohol use and numerous medical complications and behavioural problems. Behavioural problems associated with risky alcohol use included verbal abuse, agitation and sleep disturbances, particularly in men; problems associated with tobacco use included agitation and non-compliance. Orthopaedic patients who smoke and/or drink heavily prior to surgery may have more non-medical complications than non-smokers and light or non-drinkers. All surgery patients should thus be screened for alcohol and tobacco use and alcohol withdrawal, which may cause other symptoms such as behavioural problems, non-compliance and verbal abuse post-surgery.

Correlations of radiological assessment of skeletal maturity and orthopaedic injuries in the standardbred

International Nuclear Information System (INIS)

Pasolini, M.P.; Meomartino, L.; Fatone, G.; Brunetti, A.; Laratta, I.

2003-01-01

The aim of this study was to define a correlation between the incidence of orthopaedic injuries and the skeletal maturity, radiologically assessed, in a group of 23 standardbred horses. Starting at 18 months of age, radiograms of calcaneus and distal radial physis were taken at two months intervals, until X-ray evidence of closure. All the physis were blindly graded as: C: open physis; B-: initial evidence of central closure; B: partially closed physis; B+: full closure of the central portion of the physis; A: closed physis. Based on this classification, the horses were grouped as I (immature subject - C, B- and B), or M (mature subject - B+ and A). Orthopaedic injuries were classified as major lesion, if causing prolonged or definitive interruption of training, or minor, if causing brief or no interruption of training. Estimation of injury incidence in the different groups was calculated using the chi-square test (significance level P0.01). The average ages of physis closure (mean +- SD) were 24.1 +- 2.6 months (range 19-28), for the calcaneal physis, and 28.2 +- 2 months (range 26-33), for the distal radial physis, without significant differences between colts and fillies. In our study, according to a previous report, no correlation between X-ray skeletal maturity and incidence of orthopaedic injuries was demonstrated [it

An interpretation of the behavior of EoS/GE models for asymmetric systems

DEFF Research Database (Denmark)

Kontogeorgis, Georgios; Panayiotis, Vlamos

2000-01-01

or zero pressure or at other conditions (system's pressure, constant volume packing fraction). In a number of publications over the last years, the achievements and the shortcomings of the various EoS/G(E) models have been presented via phase equilibrium calculations. This short communication provides...... an explanation of several literature EoSIGE models, especially those based on zero-reference pressure (PSRK, MHV1, MHV2), in the prediction of phase equilibria for asymmetric systems as well as an interpretation of the LCVM and kappa-MHV1 models which provide an empirical - yet as shown here theoretically...... justified - solution to these problems. (C) 2000 Elsevier Science Ltd. All rights reserved....

System testing software deployments using Docker and Kubernetes in gitlab CI: EOS + CTA use case

CERN Document Server

CERN. Geneva

2017-01-01

It needs to be seamlessly integrated with `EOS`, which has become the de facto disk storage system at CERN. `CTA` and `EOS` integration requires parallel development of features in both software that needs to be **synchronized and systematically tested** on a specific distributed development infrastructure for each commit in the code base. This presentation describes the full gitlab continuous integration work flow that builds, tests, deploys and run system tests of the full software stack in docker containers on our specific kubernetes infrastructure.

Protected Time for Research During Orthopaedic Residency Correlates with an Increased Number of Resident Publications.

Science.gov (United States)

Williams, Benjamin R; Agel, Julie A; Van Heest, Ann E

2017-07-05

The Accreditation Council for Graduate Medical Education (ACGME) requires orthopaedic residency programs to promote scholarship and research, which manifest differently among programs. We assess the impact of protected research time during orthopaedic residency on the number of resident publications. Rotation schedules and resident names were collected from 125 ACGME-accredited U.S. orthopaedic residency programs. Protected research time was classified as 1 of 3 types: (1) block time, (2) longitudinal time, or (3) no dedicated time. In April 2016, we searched residents in postgraduate year (PGY)-3 to PGY-5 on pubmed.gov to generate all orthopaedic publications with a PubMed identifier published during residency. Each publication's 2015 Thomson Reuters Journal Citation Reports 5-Year Journal Impact Factor and resident first authorship were noted. The number of PubMed identifiers for each program was summed and was divided by the number of residents in PGY-3 to PGY-5, giving a mean number of publications per resident. The relationship between output and program research time was compared using t tests and analysis of variance (ANOVA). A total of 1,690 residents were included, with an overall mean number (and standard deviation) of 1.2 ± 2.4 publications per resident. Eighty-seven programs reported block time, 14 programs reported longitudinal time, and 24 programs reported no time. There was a significant difference (p = 0.02) in the mean number of publications per resident when compared between programs with protected time (1.1 ± 1.2 publications) and programs with no protected time (0.6 ± 0.5 publication). One-way ANOVA demonstrated a significant mean difference across the 3 groups (p publications than block time at 1.0 ± 1.0 publication or no time at 0.6 ± 0.5 publication, a difference that persisted when adjusted to include only impact factors of >0 and exclude case reports (p = 0.0015). Both the presence of and the type of dedicated research time correlate

Readability of sports medicine-related patient education materials from the American Academy of Orthopaedic Surgeons and the American Orthopaedic Society for Sports Medicine.

Science.gov (United States)

Ganta, Abhishek; Yi, Paul H; Hussein, Khalil; Frank, Rachel M

2014-04-01

Although studies have revealed high readability levels of orthopedic patient education materials, no study has evaluated sports medicine-related patient education materials. We conducted a study to assess the readability of sports medicine-related patient education materials from the American Academy of Orthopaedic Surgeons (AAOS) and the American Orthopaedic Society for Sports Medicine (AOSSM). All sports medicine patient education articles available online in 2012 from the AAOS and the AOSSM, including the Stop Sports Injuries Campaign (STOP), were identified, and their readability was assessed with the Flesch-Kinkaid (FK) readability test. Mean overall FK grade level of the 170 articles reviewed (104 from AAOS, 36 from AOSSM, 30 from STOP) was 10.2. Mean FK levels for the 3 sources were 9.5 (AAOS), 11.0 (AOSSM), and 11.5 (STOP) (P = .16). Fifteen (8.8%) of the 170 articles had a readability level at or below eighth grade (average reading level of US adults); only 2 (1.2%) of the 170 articles were at or below the recommended sixth-grade level. The majority of sports medicine-related patient education materials from AAOS and AOSSM had reading levels higher than recommended, indicating that the majority of the patient population may find it difficult to comprehend these articles.

The presentation of rickets to orthopaedic clinics: return of the English disease.

Science.gov (United States)

Naseem, Haris; Wall, Alun P; Sangster, Marshall; Paton, Robin W

2011-04-01

Rickets is a potentially treatable disease of the bone that is most commonly due to deficiency of vitamin D and is increasing in incidence in developed countries. Risk factors include dietary factors, the practice of covering up and darker skin pigmentation. This small retrospective case study set out to examine all cases of rickets presenting to the Paediatric Orthopaedic clinic over a 15-month period. Rickets presented in a bimodal fashion in the 6 cases identified: in males and females aged 3 or less and female adolescents aged 10 and above. This is in keeping with what is known regarding the rapid phases of growth during development. Five cases were from ethnic minority groups. Both female adolescents presented with genu valgum. Rickets can present primarily to Orthopaedic clinics with vague musculoskeletal symptoms. We recommend that biochemical screening be performed on patients from ethnic minorities who may be 'at risk'.

The Relationship of Obesity to Increasing Health-Care Burden in the Setting of Orthopaedic Polytrauma.

Science.gov (United States)

Licht, Heather; Murray, Mark; Vassaur, John; Jupiter, Daniel C; Regner, Justin L; Chaput, Christopher D

2015-11-18

With the rise of obesity in the American population, there has been a proportionate increase of obesity in the trauma population. The purpose of this study was to use a computed tomography-based measurement of adiposity to determine if obesity is associated with an increased burden to the health-care system in patients with orthopaedic polytrauma. A prospective comprehensive trauma database at a level-I trauma center was utilized to identify 301 patients with polytrauma who had orthopaedic injuries and intensive care unit admission from 2006 to 2011. Routine thoracoabdominal computed tomographic scans allowed for measurement of the truncal adiposity volume. The truncal three-dimensional reconstruction body mass index was calculated from the computed tomography-based volumes based on a previously validated algorithm. A truncal three-dimensional reconstruction body mass index of obese patients and ≥ 30 kg/m(2) denoted obese patients. The need for orthopaedic surgical procedure, in-hospital mortality, length of stay, hospital charges, and discharge disposition were compared between the two groups. Of the 301 patients, 21.6% were classified as obese (truncal three-dimensional reconstruction body mass index of ≥ 30 kg/m(2)). Higher truncal three-dimensional reconstruction body mass index was associated with longer hospital length of stay (p = 0.02), more days spent in the intensive care unit (p = 0.03), more frequent discharge to a long-term care facility (p obesity on patients with polytrauma. Obese patients were found to have higher total hospital charges, longer hospital stays, discharge to a continuing-care facility, and a higher rate of orthopaedic surgical intervention. Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.

The ASY-EOS Experiment at GSI

Directory of Open Access Journals (Sweden)

Russotto P.

2016-01-01

Full Text Available The elliptic-flow ratio of neutrons with respect to protons or light complex particles in reactions of heavy ions at pre-relativistic energies has been proposed as an observable sensitive to the strength of the symmetry term of the nuclear equation of state at supra-saturation densities. In the ASY-EOS experiment at the GSI laboratory, flows of neutrons and light charged particles were measured for 197Au+197Au collisions at 400 MeV/nucleon. Flow results obtained for the Au+Au system, in comparison with predictions of the UrQMD transport model, confirm the moderately soft to linear density dependence of the symmetry energy deduced from the earlier FOPI-LAND data.

77 FR 59567 - Retrospective Regulatory Review Under E.O. 13563

Science.gov (United States)

2012-09-28

... #0;notices is to give interested persons an opportunity to participate in #0;the rule making prior to... Immigration Review 8 CFR Parts 1003, 1103, 1208, 1211, 1212, 1215, 1216, 1235 [EOIR No. 178] RIN 1125-AA71 Retrospective Regulatory Review Under E.O. 13563 AGENCY: Executive Office for Immigration Review, Department of...

Stem cells in degenerative orthopaedic pathologies: effects of aging on therapeutic potential.

Science.gov (United States)

Atesok, Kivanc; Fu, Freddie H; Sekiya, Ichiro; Stolzing, Alexandra; Ochi, Mitsuo; Rodeo, Scott A

2017-02-01

The purpose of this study was to summarize the current evidence on the use of stem cells in the elderly population with degenerative orthopaedic pathologies and to highlight the pathophysiologic mechanisms behind today's therapeutic challenges in stem cell-based regeneration of destructed tissues in the elderly patients with osteoarthritis (OA), degenerative disc disease (DDD), and tendinopathies. Clinical and basic science studies that report the use of stem cells in the elderly patients with OA, DDD, and tendinopathies were identified using a PubMed search. The studies published in English have been assessed, and the best and most recent evidence was included in the current study. Evidence suggests that, although short-term results regarding the effects of stem cell therapy in degenerative orthopaedic pathologies can be promising, stem cell therapies do not appear to reverse age-related tissue degeneration. Causes of suboptimal outcomes can be attributed to the decrease in the therapeutic potential of aged stem cell populations and the regenerative capacity of these cells, which might be negatively influenced in an aged microenvironment within the degenerated tissues of elderly patients with OA, DDD, and tendinopathies. Clinical protocols guiding the use of stem cells in the elderly patient population are still under development, and high-level randomized controlled trials with long-term outcomes are lacking. Understanding the consequences of age-related changes in stem cell function and responsiveness of the in vivo microenvironment to stem cells is critical when designing cell-based therapies for elderly patients with degenerative orthopaedic pathologies.

Expanding NASA's Land, Atmosphere Near Real-Time Capability for EOS (LANCE)

Science.gov (United States)

Davies, Diane; Michael, Karen; Masuoka, Ed; Ye, Gang; Schmaltz, Jeffrey; Harrison, Sherry; Ziskin, Daniel; Durbin, Phil B; Protack, Steve; Rinsland, Pamela Livingstone;

Canadian Orthopaedic Residents Perception of Their Needs in Elbow Surgery Teaching

Science.gov (United States)

Carroll, Michael; Drosdovech, Darren; Faber, Kenneth J.; Hildebrand, Kevin A.; King, Graham; Pollock, J.; Rouleau, Dominique M.; Sandman, Emilie

2018-01-01

Introduction: The aim of this paper is to guide training program and review course curriculum planning in elbow disorders. To this end, a nationwide email survey was administered to residents' in orthopaedic surgery training programs. Material and Methods: The survey had 12 items that examined learning needs in several domains: assessment of acute…

Mechanical model of orthopaedic drilling for augmented-haptics-based training.

Science.gov (United States)

Pourkand, Ashkan; Zamani, Naghmeh; Grow, David

2017-10-01

In this study, augmented-haptic feedback is used to combine a physical object with virtual elements in order to simulate anatomic variability in bone. This requires generating levels of force/torque consistent with clinical bone drilling, which exceed the capabilities of commercially available haptic devices. Accurate total force generation is facilitated by a predictive model of axial force during simulated orthopaedic drilling. This model is informed by kinematic data collected while drilling into synthetic bone samples using an instrumented linkage attached to the orthopaedic drill. Axial force is measured using a force sensor incorporated into the bone fixture. A nonlinear function, relating force to axial position and velocity, was used to fit the data. The normalized root-mean-square error (RMSE) of forces predicted by the model compared to those measured experimentally was 0.11 N across various bones with significant differences in geometry and density. This suggests that a predictive model can be used to capture relevant variations in the thickness and hardness of cortical and cancellous bone. The practical performance of this approach is measured using the Phantom Premium haptic device, with some required customizations. Copyright © 2017 Elsevier Ltd. All rights reserved.

Can Rheumatologists Predict Eventual Need for Orthopaedic Intervention in Patients with Rheumatoid Arthritis? Results of a Systematic Review and Analysis of Two UK Inception Cohorts

OpenAIRE

Nikiphorou, E.; Carpenter, L.; Norton, S.; Morris, S.; MacGregor, A.; Dixey, J.; Williams, P.; Kiely, P.; Walsh, D. A.; Young, A.

2017-01-01

PURPOSE OF REVIEW: The structural damage caused by rheumatoid arthritis (RA) can often be mitigated by orthopaedic surgery in late disease. This study evaluates the value of predictive factors for orthopaedic intervention. METHODS: A systematic review of literature was undertaken to identify papers describing predictive factors for orthopaedic surgery in RA. Manuscripts were selected if they met inclusion criteria of cohort study design, diagnosis of RA, follow-up duration/disease...

Rapid Prototyping in Orthopaedic Surgery: A User's Guide

Science.gov (United States)

Frame, Mark; Huntley, James S.

2012-01-01

Rapid prototyping (RP) is applicable to orthopaedic problems involving three dimensions, particularly fractures, deformities, and reconstruction. In the past, RP has been hampered by cost and difficulties accessing the appropriate expertise. Here we outline the history of rapid prototyping and furthermore a process using open-source software to produce a high fidelity physical model from CT data. This greatly mitigates the expense associated with the technique, allowing surgeons to produce precise models for preoperative planning and procedure rehearsal. We describe the method with an illustrative case. PMID:22666160

Eosinophilic Esophagitis (EoE: an emerging disease in childhood - Review of diagnostic and management strategies

Directory of Open Access Journals (Sweden)

Jorge Amil Dias

2014-11-01

Full Text Available Eosinophilic esophagitis (EoE is a chronic immune/antigen mediated inflammatory disease of the esophagus. It comprises a separate entity of increasing incidence and prevalence in children and adults. The disease is characterized by histological evidence of dense esophageal tissue eosinophilia in the presence of a variety of upper GI symptoms including vomiting, dysphagia, food impaction and odynophagia. Cornerstone of treatment is dietary intervention and/or the off-label use of swallowed topical corticosteroids. New drug therapies are under investigation. In this review we focus on the diagnostic approach and the currently available treatment strategies. Keywords: Eosinophilic esophagitis, oral viscous budesonide, fluticasone propionate, oral steroids, amino acid-based formula, empiric elimination diet, targeted elimination dietKey points:1.A trial with antisecretory medication is necessary to exclude GERD and PPI-responsive esophageal eosinophilia and to fulfil the diagnostic criteria of EoE. 2.Elimination diet and/or off-label use of topical corticosteroids are effective measures for treating EoE. 3.Elimination diet is the first line treatment in atopic children. 4.Systemic corticosteroids are reserved for patients with severe disease requiring immediate relief, or when other treatments have failed. 5.Cromolyn sodium (sodium cromoglycate and leukotriene receptor antagonists, are not currently recommended for treating EoE, due to lack of solid evidence of benefit.6.Immunosuppressive drugs and biologics have shown some value but effect has been limited and therefore not yet recommended as standard therapy.

NCO-sP(EO-stat-PO Coatings on Gold Sensors—a QCM Study of Hemocompatibility

Directory of Open Access Journals (Sweden)

Frank K. Gehring

2011-05-01

Full Text Available The reliability of implantable blood sensors is often hampered by unspecific adsorption of plasma proteins and blood cells. This not only leads to a loss of sensor signal over time, but can also result in undesired host vs. graft reactions. Within this study we evaluated the hemocompatibility of isocyanate conjugated star shaped polytheylene oxide—polypropylene oxide co-polymers NCO-sP(EO-stat-PO when applied to gold surfaces as an auspicious coating material for gold sputtered blood contacting sensors. Quartz crystal microbalance (QCM sensors were coated with ultrathin NCO-sP(EO-stat-PO films and compared with uncoated gold sensors. Protein resistance was assessed by QCM measurements with fibrinogen solution and platelet poor plasma (PPP, followed by quantification of fibrinogen adsorption. Hemocompatibility was tested by incubation with human platelet rich plasma (PRP. Thrombin antithrombin-III complex (TAT, β-thromboglobulin (β-TG and platelet factor 4 (PF4 were used as coagulation activation markers. Furthermore, scanning electron microscopy (SEM was used to visualize platelet adhesion to the sensor surfaces. Compared to uncoated gold sensors, NCO-sP(EO-stat-PO coated sensors revealed significant better resistance against protein adsorption, lower TAT generation and a lower amount of adherent platelets. Moreover, coating with ultrathin NCO-sP(EO-stat-PO films creates a cell resistant hemocompatible surface on gold that increases the chance of prolonged sensor functionality and can easily be modified with specific receptor molecules.

What factors influence the production of orthopaedic research in East Africa? A qualitative analysis of interviews.

Science.gov (United States)

Elliott, Iain S; Sonshine, Daniel B; Akhavan, Sina; Slade Shantz, Angelique; Caldwell, Amber; Slade Shantz, Jesse; Gosselin, Richard A; Coughlin, R Richard

2015-06-01

Research addressing the burden of musculoskeletal disease in low- and middle-income countries does not reflect the magnitude of the epidemic in these countries as only 9% of the world's biomedical resources are devoted to addressing problems that affect the health of 90% of the world's population. Little is known regarding the barriers to and drivers of orthopaedic surgery research in such resource-poor settings, the knowledge of which would help direct specific interventions for increasing research capacity and help surgeons from high-income countries support the efforts of our colleagues in low- and middle-income countries. We sought to identify through surveying academic orthopaedic surgeons in East Africa: (1) barriers impeding research, (2) factors that support or drive research, and (3) factors that were identified by some surgeons as barriers and others as drivers (what we term barrier-driver overlap) as they considered the production of clinical research in resource-poor environments. Semistructured interviews were conducted with 21 orthopaedic surgeon faculty members at four academic medical centers in Ethiopia, Kenya, Tanzania, and Uganda. Qualitative content analysis of the interviews was conducted using methods based in grounded theory. Grounded theory begins with qualitative data, such as interview transcripts, and analyzes the data for repeated ideas or concepts which then are coded and grouped into categories which allow for identification of subjects or problems that may not have been apparent previously to the interviewer. We identified and quantified 19 barriers to and 21 drivers of orthopaedic surgery research (mentioned n = 1688 and n = 1729, respectively). Resource, research process, and institutional domains were identified to categorize the barriers (n = 7, n = 5, n = 7, respectively) and drivers (n = 7, n = 8, n = 6, respectively). Resource barriers (46%) were discussed more often by interview subjects compared with the

The available evidence on demineralised bone matrix in trauma and orthopaedic surgery

NARCIS (Netherlands)

J. van der Stok (Johan); Hartholt, K.A.; Schoenmakers, D.A.L.; J.J. Arts (Jacobus J.)

2017-01-01

textabstractObjectives: The aim of this systematic literature review was to assess the clinical level of evidence of commercially available demineralised bone matrix (DBM) products for their use in trauma and orthopaedic related surgery. Methods: A total of 17 DBM products were used as search terms

Clinical validation of a body-fixed 3D accelerometer and algorithm for activity monitoring in orthopaedic patients

Directory of Open Access Journals (Sweden)

Matthijs Lipperts

2017-10-01

Conclusion: Activity monitoring of orthopaedic patients by counting and timing a large set of relevant daily life events is feasible in a user- and patient-friendly way and at high clinical validity using a generic three-dimensional accelerometer and algorithms based on empirical and physical methods. The algorithms performed well for healthy individuals as well as patients recovering after total joint replacement in a challenging validation set-up. With such a simple and transparent method real-life activity parameters can be collected in orthopaedic practice for diagnostics, treatments, outcome assessment, or biofeedback.

Burnout and quality of life among orthopaedic trainees in a modern educational programme: importance of the learning climate.

Science.gov (United States)

van Vendeloo, S N; Brand, P L P; Verheyen, C C P M

2014-08-01

We aimed to determine quality of life and burnout among Dutch orthopaedic trainees following a modern orthopaedic curriculum, with strict compliance to a 48-hour working week. We also evaluated the effect of the clinical climate of learning on their emotional well-being. We assessed burnout, quality of life and the clinical climate of learning in 105 orthopaedic trainees using the Maslach Burnout Inventory, linear analogue scale self-assessments, and Dutch Residency Educational Climate Test (D-RECT), respectively. A total of 19 trainees (18%) had poor quality of life and 49 (47%) were dissatisfied with the balance between their personal and professional life. Some symptoms of burnout were found in 29 trainees (28%). Higher D-RECT scores (indicating a better climate of learning) were associated with a better quality of life (r = 0.31, p = 0.001), more work-life balance satisfaction (r = 0.31, p = 0.002), fewer symptoms of emotional exhaustion (r = -0.21, p = 0.028) and depersonalisation (r = -0,28, p = 0.04). A reduced quality of life with evidence of burnout were still seen in a significant proportion of orthopaedic trainees despite following a modern curriculum with strict compliance to a 48-hour working week. It is vital that further work is undertaken to improve the quality of life and reduce burnout in this cohort. ©2014 The British Editorial Society of Bone & Joint Surgery.

Oral appliances and functional orthopaedic appliances for obstructive sleep apnoea in children.

Science.gov (United States)

Carvalho, Fernando R; Lentini-Oliveira, Débora A; Prado, Lucila Bf; Prado, Gilmar F; Carvalho, Luciane Bc

2016-10-05

Apnoea is a breathing disorder marked by the absence of airflow at the nose or mouth. In children, risk factors include adenotonsillar hypertrophy, obesity, neuromuscular disorders and craniofacial anomalies. The most common treatment for obstructive sleep apnoea syndrome (OSAS) in childhood is adeno-tonsillectomy. This approach is limited by its surgical risks, mostly in children with comorbidities and, in some patients, by recurrence that can be associated with craniofacial problems. Oral appliances and functional orthopaedic appliances have been used for patients who have OSAS and craniofacial anomalies because they hold the lower jaw (mandible) forwards which potentially enlarges the upper airway and increases the upper airspace, improving the respiratory function. To assess the effects of oral appliances or functional orthopaedic appliances for obstructive sleep apnoea in children. We searched the following electronic databases: Cochrane Oral Health's Trials Register (to 7 April 2016); Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 3) in the Cochrane Library (searched 7 April 2016); MEDLINE Ovid (1946 to 7 April 2016); Embase Ovid (1980 to 7 April 2016); LILACS BIREME (from 1982 to 7 April 2016); BBO BIREME (from 1986 to 7 April 2016) and SciELO Web of Science (from 1997 to 7 April 2016). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials on 7 April 2016. We placed no restrictions on the language or date of publication when searching the electronic databases. All randomised or quasi-randomised controlled trials comparing all types of oral and functional orthopaedic appliances with placebo or no treatment, in children 15 years old or younger. reduction of apnoea to less than one episode per hour. dental and skeletal relationship, sleep parameters improvement, cognitive and phonoaudiological function, behavioural problems, quality of life, side effects

Web Monitoring of EOS Front-End Ground Operations, Science Downlinks and Level 0 Processing

Science.gov (United States)

Cordier, Guy R.; Wilkinson, Chris; McLemore, Bruce

2008-01-01

This paper addresses the efforts undertaken and the technology deployed to aggregate and distribute the metadata characterizing the real-time operations associated with NASA Earth Observing Systems (EOS) high-rate front-end systems and the science data collected at multiple ground stations and forwarded to the Goddard Space Flight Center for level 0 processing. Station operators, mission project management personnel, spacecraft flight operations personnel and data end-users for various EOS missions can retrieve the information at any time from any location having access to the internet. The users are distributed and the EOS systems are distributed but the centralized metadata accessed via an external web server provide an effective global and detailed view of the enterprise-wide events as they are happening. The data-driven architecture and the implementation of applied middleware technology, open source database, open source monitoring tools, and external web server converge nicely to fulfill the various needs of the enterprise. The timeliness and content of the information provided are key to making timely and correct decisions which reduce project risk and enhance overall customer satisfaction. The authors discuss security measures employed to limit access of data to authorized users only.

Effect of extended scope physiotherapists assessments in orthopaedic diagnostic setting: a systematic review

DEFF Research Database (Denmark)

Trøstrup, Jeanette; Juhl, Carsten Bogh; Mikkelsen, Lone Ramer

2017-01-01

Background Patients with musculoskeletal diseases can potentially be assessed by an extended scope physiotherapist (ESP) instead of by an orthopaedic surgeon (OS). Objectives To evaluate the effectiveness of the diagnostic musculoskeletal assessment performed by ESP compared to OS. Data sources M...

Imaging of Periprosthetic Infection.

LENUS (Irish Health Repository)

Carty, Fiona

2013-05-22

Periprosthetic infection is one of the most challenging and difficult complications in orthopaedics. It can result in significant patient distress and disability, with repeated surgeries, increased cost and utilization of medical resources, and in rare cases even mortality. The biggest challenge to date is the correct diagnosis of periprosthetic infection and implementation of effective treatment regimens capable of eradicating the organism. This article reviews the various modalities used in the imaging of periprosthetic and post-arthroplasty infection.

Practice Pattern Variation in Pediatric Eosinophilic Esophagitis in the Carolinas EoE Collaborative: A Research Model in Community and Academic Practices.

Science.gov (United States)

Huang, Kevin Z; Jensen, Elizabeth T; Chen, Hannah X; Landes, Lisa E; McConnell, Kristen A; Almond, M Angie; Johnston, Douglas T; Durban, Raquel; Jobe, Laura; Frost, Carrie; Donnelly, Sarah; Antonio, Brady; Safta, Anca M; Quiros, J Antonio; Markowitz, Jonathan E; Dellon, Evan S

2018-06-01

Differences in the initial management of pediatric eosinophilic esophagitis (EoE) by practice setting have not been well characterized. We aimed to characterize these differences for sites in the Carolinas EoE Collaborative (CEoEC), a multicenter network of academic and community practices. We performed a retrospective cohort study of pediatric EoE patients at five CEoEC sites: University of North Carolina (UNC) Hospital, Charlotte Asthma and Allergy Specialists, Greenville Health Systems, Wake Forest Baptist Medical Center, and the Medical University of South Carolina Hospital. Cases of EoE were defined by consensus guidelines. Data were extracted from electronic medical records. We tested for differences among sites and used a multinomial model (polytomous regression) to assess associations between treatment and site, adjusting on patient factors. We identified 464 children with EoE across the CEoEC sites. The median age was highest at Wake Forest (11.4 years), the median eosinophil count was highest at UNC (69 eos/hpf), and UNC had the most male patients (82%). UNC used topical steroids for initial treatment in 86% of cases, compared with <1% in Greenville ( P < 0.01). Greenville used dietary elimination more frequently than UNC (81% vs 2%, P < 0.01). Differences in treatment approach held after adjusting for potential baseline confounders. There was no significant association between patient factors and initial treatment approach. Significant differences in EoE patient factors and treatment approaches were identified across CEoEC sites and were not explained by patient or practice factors. This suggests that institutional or provider preferences drive initial treatment approaches, and that more data are needed to drive best practice decisions.

Impact and alternative metrics for medical publishing: our experience with International Orthopaedics.

Science.gov (United States)

Scarlat, Marius M; Mavrogenis, Andreas F; Pećina, Marko; Niculescu, Marius

2015-08-01

This paper compares the traditional tools of calculation for a journal's efficacy and visibility with the new tools that have arrived from the Internet, social media and search engines. The examples concern publications of orthopaedic surgery and in particular International Orthopaedics. Until recently, the prestige of publications, authors or journals was evaluated by the number of citations using the traditional citation metrics, most commonly the impact factor. Over the last few years, scientific medical literature has developed exponentially. The Internet has dramatically changed the way of sharing and the speed of flow of medical information. New tools have allowed readers from all over the world to access information and record their experience. Web platforms such as Facebook® and Twitter® have allowed for inputs from the general public. Professional sites such as LinkedIn® and more specialised sites such as ResearchGate®, BioMed Central® and OrthoEvidence® have provided specific information on defined fields of science. Scientific and professional blogs provide free access quality information. Therefore, in this new era of advanced wireless technology and online medical communication, the prestige of a paper should also be evaluated by alternative metrics (altmetrics) that measure the visibility of the scientific information by collecting Internet citations, number of downloads, number of hits on the Internet, number of tweets and likes of scholarly articles by newspapers, blogs, social media and other sources of data. This article provides insights into altmetrics and informs the reader about current tools for optimal visibility and citation of their work. It also includes useful information about the performance of International Orthopaedics and the bias between traditional publication metrics and the new alternatives.

Intention-to-treat analysis and accounting for missing data in orthopaedic randomized clinical trials.

Science.gov (United States)

Herman, Amir; Botser, Itamar Busheri; Tenenbaum, Shay; Chechick, Ahron

2009-09-01

The intention-to-treat principle implies that all patients who are randomized in a clinical trial should be analyzed according to their original allocation. This means that patients crossing over to another treatment group and patients lost to follow-up should be included in the analysis as a part of their original group. This principle is important for preserving the randomization scheme, which is the basis for correct inference in any randomized trial. In this study, we examined the use of the intention-to-treat principle in recently published orthopaedic clinical trials. We surveyed eight leading orthopaedic journals for randomized clinical trials published between January 2005 and August 2008. We determined whether the intention-to-treat principle was implemented and, if so, how it was used in each trial. Specifically, we ascertained which methods were used to account for missing data. Our search yielded 274 randomized clinical trials, and the intention-to-treat principle was used in ninety-six (35%) of them. There were significant differences among the journals with regard to the use of the intention-to-treat principle. The relative number of trials in which the principle was used increased each year. The authors adhered to the strict definition of the intention-to-treat principle in forty-five of the ninety-six studies in which it was claimed that this principle had been used. In forty-four randomized trials, patients who had been lost to follow-up were excluded from the final analysis; this practice was most notable in studies of surgical interventions. The most popular method of adjusting for missing data was the "last observation carried forward" technique. In most of the randomized clinical trials published in the orthopaedic literature, the investigators did not adhere to the stringent use of the intention-to-treat principle, with the most conspicuous problem being a lack of accounting for patients lost to follow-up. This omission might introduce bias to

Twenty years of meta-analyses in orthopaedic surgery: has quality kept up with quantity?

Science.gov (United States)

Dijkman, Bernadette G; Abouali, Jihad A K; Kooistra, Bauke W; Conter, Henry J; Poolman, Rudolf W; Kulkarni, Abhaya V; Tornetta, Paul; Bhandari, Mohit

2010-01-01

As the number of studies in the literature is increasing, orthopaedic surgeons highly depend on meta-analyses as their primary source of scientific evidence. The objectives of this review were to assess the scientific quality and number of published meta-analyses on orthopaedics-related topics over time. We conducted, in duplicate and independently, a systematic review of published meta-analyses in orthopaedics in the years 2005 and 2008 and compared them with a previous systematic review of meta-analyses from 1969 to 1999. A search of electronic databases (MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews) was performed to identify meta-analyses published in 2005 and 2008. We searched bibliographies and contacted content experts to identify additional relevant studies. Two investigators independently assessed the quality of the studies, using the Oxman and Guyatt index, and abstracted relevant data. We included forty-five and forty-four meta-analyses from 2005 and 2008, respectively. While the number of meta-analyses increased fivefold from 1999 to 2008, the mean quality score did not change significantly over time (p = 0.067). In the later years, a significantly lower proportion of meta-analyses had methodological flaws (56% in 2005 and 68% in 2008) compared with meta-analyses published prior to 2000 (88%) (p = 0.006). In 2005 and 2008, respectively, 18% and 30% of the meta-analyses had major to extensive flaws in their methodology. Studies from 2008 with positive conclusions used and described appropriate criteria for the validity assessment less often than did those with negative results. The use of random-effects and fixed-effects models as pooling methods became more popular toward 2008. Although the methodological quality of orthopaedic meta-analyses has increased in the past twenty years, a substantial proportion continues to show major to extensive flaws. As the number of published meta-analyses is increasing, a routine checklist for

The effect of tributyltin on human eosinophilic [correction of eosinophylic] leukemia EoL-1 cells.

Science.gov (United States)

Sroka, Jolanta; Włosiak, Przemysław; Wilk, Anna; Antonik, Justyna; Czyz, Jarosław; Madeja, Zbigniew

2008-01-01

Organotin compounds are chemicals that are widely used in industry and agriculture as plastic stabilizers, catalysts and biocides. Many of them, including tributyltin (TBT), have been detected in human food and, as a consequence, detectable levels have been found in human blood. As organotin compounds were shown to possess immunotoxic activity, we focused our attention on the effect of TBT on the basic determinants of the function of eosinophils, i.e. cell adhesiveness and motility. We used human eosinophylic leukemia EoL-1 cells, a common in vitro cellular model of human eosinophils. Here, we demonstrate that TBT causes a dose-dependent decrease in the viability of EoL-1 cells. When administered at sub-lethal concentrations, TBT significantly decreases the adhesion of EoL-1 cells to human fibroblasts (HSFs) and inhibits their migration on fibroblast surfaces. Since the basic function of eosinophils is to invade inflamed tissues, our results indicate that TBT, and possibly other organotin compounds, may affect major cellular properties involved in the determination of in vivo eosinophil function.

Internet based patient education improves informed consent for elective orthopaedic surgery: a randomized controlled trial.

Science.gov (United States)

Fraval, Andrew; Chandrananth, Janan; Chong, Yew M; Coventry, Lillian S; Tran, Phong

2015-02-07

Obtaining informed consent is an essential step in the surgical pathway. Providing adequate patient education to enable informed decision making is a continued challenge of contemporary surgical practice. This study investigates whether the use of a patient information website, to augment patient education and informed consent for elective orthopaedic procedures is an effective measure. A randomised controlled trial was conducted comparing the quality of informed consent provided by a standard discussion with the treating surgeon compared to augmentation of this discussion with an online education resource (www.orthoanswer.org). Participants were recruited from orthopaedic outpatient clinics. Patients undergoing five common orthopaedic procedures were eligible to participate in the trial. The primary outcome measure was knowledge about their operation. Satisfaction with their informed consent and anxiety relating to their operation were the secondary outcome measures. There was a statistically significant increase in patient knowledge for the intervention arm as compared to the control arm (p education website as an augment to informed consent improves patient knowledge about their planned operation as well as satisfaction with the consent process whilst not increasing their anxiety levels. We recommend that all patients be directed to web based education tools to augment their consent. Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12614001058662 .

The effectiveness of methicillin-resistant Staphylococcus aureus colonisation screening in asymptomatic healthcare workers in an Irish orthopaedic unit.

LENUS (Irish Health Repository)

Edmundson, S P

2012-01-31

Methicillin-resistant Staphylococcus aureus (MRSA) infections are associated with increased mortality, costs and length of stay compared to non-MRSA infections. This observational 4-year study analyses the impact of screening and treating orthopaedic healthcare workers for MRSA colonisation. A total of 1,011 swabs were taken from 566 healthcare workers. Positive healthcare workers were treated with topical mupirocin to both anterior nares. The prevalence of MRSA colonisation on initial testing was 4.77%. The rate of positive MRSA colonisation of those tested on more than one occasion fell from 5.88% to 2.71% (p = 0.055) on subsequent screening. All healthcare workers receiving treatment were successfully cleared of colonisation; however, some required more than one course of treatment. These results show that there could be a role for screening and treating orthopaedic staff for MRSA colonisation as part of a strategy to reduce the prevalence of MRSA infections in orthopaedic units.

Complex orthopaedic management of patients with skeletal dysplasias

Directory of Open Access Journals (Sweden)

A. G. Baindurashvili

2014-01-01

Full Text Available Skeletal dysplasias are challenging for diagnostics and treatment. We present a series of fifteen patients with different forms of skeletal dysplasias with age ranged from 6 to 17 years with variable clinical presentations managed as a part of the project of scientific cooperation between Turner Paediatric Orthopaedic Institute and Orthopaedic Hospital Vienna-Speising. The spectrum of diagnoses included multiple epiphyseal dysplasia, spondyloepiphyseal dysplasia congenita, diastrophic dysplasia, metaphyseal dysplasia, spondylometaphyseal dysplasia, Stickler syndrome, Kniest dysplasia, and anauxetic dysplasia. Complex treatment, which included axial correction and juxta-articular realignment, was performed as a single-stage, or consecutive surgery. Surgical techniques included corrective osteotomies with internal fixation, guided growth technique and external fixation devices. Best results (full axial correction, normal alignment of the joint were achieved in 8 patients, including 2 patients with metaphyseal dysplasia, 2 patients with multiple epyphyseal dysplasia, 2 patients with spondyloepyphyseal dysplasia, patient with Stickler syndrome and patient with spondylometaphyseal dysplasia. Good results (partial correction at the present time were seen in 4 patients (2 patients with Kniest dysplasia, 1 - with multiple epyphyseal dysplasia and 1 - with anauxetic dysplasia. Satisfactory results (non-progressive condition in previous progression were obtained in 2 patients with diastrophic dysplasia, and poor results (progression of the deformity - in 1 patient with diastrophic dysplasia. Positive results in most of the cases of our series make promising future for usage of complex approach for orthopedic management of children with skeletal dysplasias; advanced international cooperation is productive and helpful for diagnostics and management of rare diseases.

EOS Operations Systems: EDOS Implemented Changes to Reduce Operations Costs

Science.gov (United States)

Cordier, Guy R.; Gomez-Rosa, Carlos; McLemore, Bruce D.

2007-01-01

The authors describe in this paper the progress achieved to-date with the reengineering of the Earth Observing System (EOS) Data and Operations System (EDOS), the experience gained in the process and the ensuing reduction of ground systems operations costs. The reengineering effort included a major methodology change, applying to an existing schedule driven system, a data-driven system approach.

Using NASA EOS in the Arabian and Saharan Deserts to Examine Dust Particle Size and Spectral Signature of Aerosols

Science.gov (United States)

Brenton, J. C.; Keeton, T.; Barrick, B.; Cowart, K.; Cooksey, K.; Florence, V.; Herdy, C.; Luvall, J. C.; Vasquez, S.

2012-12-01

Exposure to high concentrations of airborne particulate matter can have adverse effects on the human respiratory system. Ground-based studies conducted in Iraq have revealed the presence of potential human pathogens in airborne dust. According to the Environmental Protection Agency (EPA), airborne particulate matter below 2.5μm (PM2.5) can cause long-term damage to the human respiratory system. Given the relatively high incidence of new-onset respiratory disorders experienced by US service members deployed to Iraq, this research offers a new glimpse into how satellite remote sensing can be applied to questions related to human health. NASA's Earth Observing System (EOS) can be used to determine spectral characteristics of dust particles, the depth of dust plumes, as well as dust particle sizes. Comparing dust particle size from the Sahara and Arabian Deserts gives insight into the composition and atmospheric transport characteristics of dust from each desert. With the use of NASA SeaWiFS DeepBlue Aerosol, dust particle sizes were estimated using Angström exponent. Brightness Temperature Difference (BTD) equation was used to determine the distribution of particle sizes, the area of the dust storm, and whether silicate minerals were present in the dust. The Moderate-resolution Imaging Spectroradiometer (MODIS) on Terra satellite was utilized in calculating BTD. Minimal research has been conducted on the spectral characteristics of airborne dust in the Arabian and Sahara Deserts. Mineral composition of a dust storm that occurred 17 April 2008 near Baghdad was determined using imaging spectrometer data from the Jet Propulsion Laboratory Spectral Library and EO-1 Hyperion data. Mineralogy of this dust storm was subsequently compared to that of a dust storm that occurred over the Bodélé Depression in the Sahara Desert on 7 June 2003.

Conductive polymer sensor arrays for smart orthopaedic implants

Science.gov (United States)

Micolini, Carolina; Holness, F. B.; Johnson, James A.; Price, Aaron D.

2017-04-01

This study proposes and demonstrates the design, implementation, and characterization of a 3D-printed smartpolymer sensor array using conductive polyaniline (PANI) structures embedded in a polymeric substrate. The piezoresistive characteristics of PANI were studied to evaluate the efficacy of the manufacturing of an embedded pressure sensor. PANI's stability throughout loading and unloading cycles together with the response to incremental loading cycles was investigated. It is demonstrated that this specially developed multi-material additive manufacturing process for polyaniline is a good candidate for the manufacture of implant components with smart-polymer sensors embedded for the analysis of joint loads in orthopaedic implants.

Churg-Strauss syndrome from an orthopaedic perspective.

Science.gov (United States)

Kung, K L; Yee, P K

2015-12-01

Churg-Strauss syndrome, which has been frequently described by physicians in the literature, is a small and medium-sized vessel systemic vasculitis typically associated with asthma, lung infiltrates, and hypereosinophilia. We report a case of Churg-Strauss syndrome with presenting symptoms of bilateral lower limb weakness and numbness only. The patient was admitted to an orthopaedic ward for management and a final diagnosis was reached following sural nerve biopsy. The patient's symptoms responded promptly to steroid treatment and she was able to walk with a stick 3 weeks following admission. This report emphasises the need to be aware of this syndrome when managing patients with neurological deficit in order to achieve prompt diagnosis and treatment.

A pilot study of orthopaedic resident self-assessment using a milestones' survey just prior to milestones implementation.

Science.gov (United States)

Bradley, Kendall E; Andolsek, Kathryn M

2016-01-11

To pilot test if Orthopaedic Surgery residents could self-assess their performance using newly created milestones, as defined by the Accreditation Council on Graduate Medical Education. In June 2012, an email was sent to Program Directors and administrative coordinators of the 154 accredited Orthopaedic Surgery Programs, asking them to send their residents a link to an online survey. The survey was adapted from the Orthopaedic Surgery Milestone Project. Completed surveys were aggregated in an anonymous, confidential database. SAS 9.3 was used to perform the analyses. Responses from 71 residents were analyzed. First and second year residents indicated through self-assessment that they had substantially achieved Level 1 and Level 2 milestones. Third year residents reported they had substantially achieved 30/41, and fourth year residents, all Level 3 milestones. Fifth year, graduating residents, reported they had substantially achieved 17 Level 4 milestones, and were extremely close on another 15. No milestone was rated at Level 5, the maximum possible. Earlier in training, Patient Care and Medical Knowledge milestones were rated lower than the milestones reflecting the other four competencies of Practice Based Learning and Improvement, Systems Based Practice, Professionalism, and Interpersonal Communication. The gap was closed by the fourth year. Residents were able to successfully self-assess using the 41 Orthopaedic Surgery milestones. Respondents' rate improved proficiency over time. Graduating residents report they have substantially, or close to substantially, achieved all Level 4 milestones. Milestone self-assessment may be a useful tool as one component of a program's overall performance assessment strategy.

A pilot study of orthopaedic resident self-assessment using a milestones’ survey just prior to milestones implementation

Science.gov (United States)

Bradley, Kendall E.

2016-01-01

Objectives To pilot test if Orthopaedic Surgery residents could self-assess their performance using newly created milestones, as defined by the Accreditation Council on Graduate Medical Education.  Methods In June 2012, an email was sent to Program Directors and administrative coordinators of the154 accredited Orthopaedic Surgery Programs, asking them to send their residents a link to an online survey. The survey was adapted from the Orthopaedic Surgery Milestone Project. Completed surveys were aggregated in an anonymous, confidential database. SAS 9.3 was used to perform the analyses. Results Responses from 71 residents were analyzed. First and second year residents indicated through self-assessment that they had substantially achieved Level 1 and Level 2 milestones. Third year residents reported they had substantially achieved 30/41, and fourth year residents, all Level 3 milestones. Fifth year, graduating residents, reported they had substantially achieved 17 Level 4 milestones, and were extremely close on another 15. No milestone was rated at Level 5, the maximum possible.  Earlier in training, Patient Care and Medical Knowledge milestones were rated lower than the milestones reflecting the other four competencies of Practice Based Learning and Improvement, Systems Based Practice, Professionalism, and Interpersonal Communication. The gap was closed by the fourth year. Conclusions Residents were able to successfully self-assess using the 41 Orthopaedic Surgery milestones. Respondents’ rate improved proficiency over time. Graduating residents report they have substantially, or close to substantially, achieved all Level 4 milestones.  Milestone self-assessment may be a useful tool as one component of a program’s overall performance assessment strategy. PMID:26752012

The impact of orthopaedic injuries sustained at an urban public ice skating rink: is it really free?

Science.gov (United States)

Schwarzkopf, Ran; Nacke, Elliot A; Tejwani, Nirmal C

2014-01-01

Previous reports in the literature from Europe and Asia cite an increased burden on the local emergency departments and orthopaedic services during the operational period of the ice skating rinks. This retrospective observational study was undertaken in order to report the incidence, characteristic, and severity of injuries during a full season at a large urban ice skating rink, as well as to quantify the added burden the ice skating rink places on the local emergency department and the orthopaedic service. All patients seen at our emergency room who sustained an injury at the neighboring "free" ice rink were identified over the 4-month period when it was open. The data collected included type of injury, demographics, and need for surgical treatment. Over this period, 118 patients were seen in our ED (of the 135 referrals from the ice rink logbook); Of these, 43 (38%) required an orthopaedic consult and were evenly divided into upper (22) and lower extremity injuries (21). Sixty-seven percent of the patients were adults, and the most common fractures were ankle and distal radius fractures. There were two open fractures of the distal radius seen in the older patients (both in patients > 50). Overall 32% of patients needed operative treatment. Of the non-orthopaedic injuries, the most common was head injury (25%). An ice-rink may be "free" but adds significant burden to the healthcare system, and these costs should be factored in by both the sponsoring body and the healthcare system for treatment of these additional patients.

Sustained lasing of HHG-seeded FEL by using EOS-based timing control

International Nuclear Information System (INIS)

Watanabe, Takahiro; Okayasu, Yuichi; Togashi, Tadashi; Hara, Toru; Tomizawa, Hiromitsu; Matsubara, Shinichi; Aoyama, Makoto; Yamakawa, Koichi; Iwasaki, Atsushi; Ohwada, Shigeki; Sato, Takahiro; Yamauchi, Kaoru; Otake, Yuji; Ohshima, Takashi; Ogawa, Kanade; Togawa, Kazuaki; Tanaka, Takashi; Takahashi, Eiji; Midorikawa, Katsumi; Yabashi, Makina; Tanaka, Hitoshi; Ishikawa, Tetsuya

2013-01-01

High-harmonic-generation (HHG) based seeded FEL experiments were demonstrated at SCSS, SPring-8. Seeded FEL has advantageous features against SASE such that there is no intrinsic nature of shot-noise fluctuation and output FEL pulses are in principle fully coherent in both transverse and longitudinal axes. In practical user experiments, however, an overlap between electron bunches and seed laser pulses in six-dimensional phase space needs to be precisely maintained for securing the stable lasing. Otherwise, the overlap could be quickly lost and the lasing is no more sustained. For the stable lasing, we have developed an EO (electro-optic) based timing control system, which enables to observe a timing drift between electron bunches and laser pulses, and compensate for it. Experimental results of the seeded FEL with and without the EO timing control are compared, and the effectiveness of the timing system is discussed. (author)

Membrane receptor-mediated apoptosis and caspase activation in the differentiated EoL-1 eosinophilic cell line.

Science.gov (United States)

Al-Rabia, Mohammed W; Blaylock, Morgan G; Sexton, Darren W; Walsh, Garry M

2004-06-01

Caspases are key molecules in the control of apoptosis, but relatively little is known about their contribution to eosinophil apoptosis. We examined caspase-3, -8, and -9 activities in receptor ligation-dependent apoptosis induction in the differentiated human eosinophilic cell line EoL-1. Differentiated EoL-1 exhibited bi-lobed nuclei, eosinophil-associated membrane receptors, and basic granule proteins. Annexin-V fluorescein isothiocyanate binding to EoL-1 revealed significant (PEoL-1 but had no effect on constitutive (baseline) apoptosis at 16 and 20 h. Caspase activity was analyzed using the novel CaspaTag trade mark technique and flow cytometry. EoL-1 treated with pan-CD45, CD45RA, CD45RB, and CD95 mAb exhibited caspase-3 and -9 activation at 12 h post-treatment, which increased at 16 and 20 h. Activated caspase-8 was detected 12 and 16 h after ligation with CD45, CD45RA, CD45RB, and CD95 mAb followed by a trend toward basal levels at 20 h. CD69 ligation resulted in caspase-3 activation, a modest but significant activation of caspase-8, and a loss in mitochondrial transmembrane potential but had no significant effect on activation of caspase-9. Thus, the intrinsic and extrinsic caspase pathways are involved in controlling receptor ligation-mediated apoptosis induction in human eosinophils, findings that may aid the development of a more targeted, anti-inflammatory therapy for asthma.

Management approach recommendations. Earth Observatory Satellite system definition study (EOS)

Science.gov (United States)

1974-01-01

Management analyses and tradeoffs were performed to determine the most cost effective management approach for the Earth Observatory Satellite (EOS) Phase C/D. The basic objectives of the management approach are identified. Some of the subjects considered are as follows: (1) contract startup phase, (2) project management control system, (3) configuration management, (4) quality control and reliability engineering requirements, and (5) the parts procurement program.

The Impact of Imaging Modality on the Measurement of Coronal Plane Alignment After Total Knee Arthroplasty.

Science.gov (United States)

Nam, Denis; Vajapey, Sravya; Nunley, Ryan M; Barrack, Robert L

2016-10-01

The optimal coronal alignment after total knee arthroplasty (TKA) has become an area of increased debate. Sources of variability among investigations include the radiographic technique used for both preoperative surgical planning and postoperative alignment assessments. This study's purpose was to assess the impact of the imaging modality used on the measurement of coronal plane alignment after TKA. A consecutive series of patients undergoing TKA using the same cruciate-retaining prosthesis were included for analysis. Postoperatively, all patients received both a rotationally controlled, scout computed tomography scan and a hip-knee-ankle (HKA) image using the EOS Imaging system (EOS Inc., Paris, France). Two, independent observers measured the HKA angle, and femoral and tibial component alignment from each image. After classifying overall and component alignment as neutral, varus, or valgus, 40.6% (65 of 160) of knees had a discordant alignment classification for HKA, 28.1% (45 of 160) for femoral component alignment, and 26.9% (43 of 160) for tibial component alignment between their computed tomography and EOS images. Overall, 24.4% (39 of 160) of patients had a HKA difference of ≥3° between the 2 images, whereas 18.8% (30 of 160) and 20.0% (32 of 160) of patients had a femoral and tibial component alignment difference of ≥2°, respectively. Significant differences are present when comparing 2 measurement techniques of mechanical alignment after TKA. The impact of imaging modality on postoperative assessments must be accounted for and be consistent when comparing the results of different investigations. Copyright © 2016 Elsevier Inc. All rights reserved.

Physiotherapy following elective orthopaedic procedures.

Science.gov (United States)

De Kleijn, P; Blamey, G; Zourikian, N; Dalzell, R; Lobet, S

2006-07-01

As haemophilic arthropathy and chronic synovitis are still the most important clinical features in people with haemophilia, different kinds of invasive and orthopaedic procedures have become more common during the last decades. The availability of clotting factor has made arthroplasty of one, or even multiple joints possible. This article highlights the role of physiotherapy before and after such procedures. Synovectomies are sometimes advocated in people with haemophilia to stop repetitive cycles of intra-articular bleeds and/or chronic synovitis. The synovectomy itself, however, does not solve the muscle atrophy, loss of range of motion (ROM), instability and poor propriocepsis, often developed during many years. The key is in taking advantage of the subsequent, relatively safe, bleed-free period to address these important issues. Although the preoperative ROM is the most important variable influencing the postoperative ROM after total knee arthroplasty, there are a few key points that should be considered to improve the outcome. Early mobilization, either manual or by means of a continuous passive mobilization machine, can be an optimal solution during the very first postoperative days. Muscle isometric contractions and light open kinetic chain exercises should also be started in order to restore the quadriceps control. Partial weight bearing can be started shortly after, because of quadriceps inhibition and to avoid excessive swelling. The use of continuous clotting factor replacement permits earlier and intensive rehabilitation during the postoperative period. During the rehabilitation of shoulder arthroplasty restoring the function of the rotator cuff is of utmost importance. Often the rotator cuff muscles are inhibited in the presence of pain and loss of ROM. Physiotherapy also assists in improving pain and maintaining ROM and strength. Functional weight-bearing tasks, such as using the upper limbs to sit and stand, are often discouraged during the first 6

Variability of Arthroscopy Case Volume in Orthopaedic Surgery Residency.

Science.gov (United States)

Gil, Joseph A; Waryasz, Gregory R; Owens, Brett D; Daniels, Alan H

2016-05-01

To examine orthopaedic surgery case logs for arthroscopy case volume during residency training and to evaluate trends in case volume and variability over time. Publicly available Accreditation Council for Graduate Medical Education surgical case logs from 2007 to 2013 for orthopaedic surgery residency were assessed for variability and case volume trends in shoulder, elbow, wrist, hip, knee, and ankle arthroscopy. The national average number of procedures performed in each arthroscopy category reported was directly compared from 2009 to 2013. The 10th and 90th percentile arthroscopy case volume was compared between 2007 and 2013 for shoulder and knee arthroscopy procedures. Subsequently, the difference between the 10th and 90th percentile arthroscopy case volume in each category in 2007 was compared with the difference between the 10th and 90th percentile arthroscopy case volume in each category in 2013. From 2007 to 2013, shoulder arthroscopy procedures performed per resident increased by 43.1% (P = .0001); elbow arthroscopy procedures increased by 28.0% (P = .00612); wrist arthroscopy procedures increased by 8.6% (P = .05); hip arthroscopy procedures, which were first reported in 2012, increased by 588.9%; knee arthroscopy procedures increased by 8.5% (P = .0435); ankle arthroscopy increased by 27.6% (P = .00149). The difference in knee and shoulder arthroscopy volume between residents in the 10th and 90th percentile in 2007 and residents in the 10th and 90th percentile in 2013 was not significant (P > .05). There was a 3.66-fold difference in knee arthroscopy volume between residents in the 10th and 90th percentile in 2007, whereas the difference was 3.36-fold in 2013 (P = .70). There was a 5.86-fold difference in shoulder arthroscopy case volume between residents in the 10th and 90th percentile in 2007, whereas the difference was 4.96-fold in 2013 (P = .29). The volume of arthroscopy cases performed by graduating orthopaedic surgery residents has

Aesthetic, urological, orthopaedic and functional outcomes in complex bladder exstrophy-epispadias's management.

Science.gov (United States)

Kouame, Bertin Dibi; Kouame, Guy Serge Yapo; Sounkere, Moufidath; Koffi, Maxime; Yaokreh, Jean Baptiste; Odehouri-Koudou, Thierry; Tembely, Samba; Dieth, Gaudens Atafi; Ouattara, Ossenou; Dick, Rufin

2015-01-01

Postoperative complications are related to the surgical procedures, of failures of initial bladder closure and influence the urological, aesthetical and orthopaedic outcomes. We reviewed four patients who underwent complex bladder exstrophy-epispadias repair over a period of 14 years. The outcomes of treatment were assessed using, aesthetic, urological and orthopaedic examination data. Orthopaedic complications were explored by a radiography of the pelvis. Out of four patients who underwent bladder exstrophy surgical management, aesthetic, functional outcomes and complications in the short and long follow-up were achieved in three patients. The first patient is a male and had a good penis aspect. He has a normal erection during micturition with a good jet miction. He has a moderate urinary incontinence, which requires diaper. In the erection, his penis-measures 4 cm long and 3 cm as circumference. The second patient was a female. She had an unsightly appearance of the female external genitalia with bipartite clitoris. Urinary continence could not be assessed; she did not have the age of cleanness yet. The third patient had a significant urinary leakage due to the failure of the epispadias repair. He has a limp, a pelvic obliquity, varus and internal rotation of the femoral head. He has an inequality of limbs length. Pelvis radiograph shows the right osteotomy through the ilium bone, the left osteotomy through the hip joint at the acetabular roof. When, the epispadias repair is performed contemporary to initial bladder closure, its success is decisive for urinary continence. In the female, surgical revision is required after the initial bladder closure for an aesthetic appearance to the external genitalia. Innominate osteotomy must be performed with brilliancy amplifier to avoid osteotomy through to the hip joint to prevent inequality in leg length.

Mission Status for Earth Science Constellation MOWG Meeting at KSC: EOS Aura

Science.gov (United States)

Fisher, Dominic

2017-01-01

This will be presented at the Earth Science Constellation Mission Operations Working Group (MOWG) meeting at KSC (Kennedy Space Center) in December 2017 to discus EOS (Earth Observing System) Aura status. Reviewed and approved by Eric Moyer, ESMO (Earth Sciences Mission Operations) Deputy Project Manager.

L4 Milestone Report for MixEOS 2016 experiments and simulations

Energy Technology Data Exchange (ETDEWEB)

Loomis, Eric Nicholas [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Bradley, Paul Andrew [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Merritt, Elizabeth Catherine [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Guzik, Joyce Ann [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Denne, Patrick Hagen [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

2016-08-01

Accurate simulations of fluid and plasma flows require accurate thermodynamic properties of the fluids or plasmas. This thermodynamic information is represented by the equations of state of the materials. For pure materials, the equations of state may be represented by analytical models for idealized circumstances, or by tabular means, such as the Sesame tables. However, when a computational cell has a mixture of two or more fluids, the equations of state are not well understood, particularly under the circumstances of high energy densities. This is a particularly difficult issue for Eulerian codes, wherein mixed cells arise simply due to the advection process. LANL Eulerian codes typically assume an “Amagat’s Law” (or Law of Partial Volumes) for the mixture in which the pressures and temperatures of fluids are at an equilibrium that is consistent with the fluids being segregated within the cell. However, for purposes of computing other EOS properties, e.g., bulk modulus, or sound speed, the fluids are considered to be fully “mixed”. LANL has also been investigating implementing instead “Dalton’s Law” in which the total pressure is considered to be the sum of the partial pressures within the cell. For ideal gases, these two laws give the same result. Other possibilities are nonpressure- temperature-equilibrated approaches in which the two fluids are not assumed to “mix” at all, and the EOS properties of the cell are computed from, say, volume-weighted averages of the individual fluid properties. The assumption of the EOS properties within a mixed cell can have a pronounced effect on the behavior of the cell, resulting in, for example, different shock speeds, pressures, temperatures and densities within the cell. There is no apparent consensus as to which approach is best under HED conditions, though we note that under typical atmospheric and near atmospheric conditions the differences may be slight.

Building A Collaborative And Distributed E&O Program For EarthScope

Science.gov (United States)

Hall-Wallace, M. K.; Boyd, T.; Richard, G.; Ellins, K.; Meertens, C.; Semken, S.; Taber, J.; Benthien, M.; Wald, L.; Marvinney, R.

2003-12-01

EarthScope's education and outreach (E&O) mission is to ensure that the EarthScope experiment creates as its legacy a public more knowledgeable and understanding of the scientific and societal contributions made by the EarthScope experiment and Earth science. It will fulfill this commitment by developing and disseminating programs and products that utilize the data, models, technology and discoveries of EarthScope. The EarthScope Education and Outreach Network (EON), consisting of local EON alliances, the EarthScope facilities, partner organizations and a coordinating office, will facilitate this E&O mission. The local EON alliances, which will vary in size and purpose to respond quickly and to meet the specific needs in a region, will carry out the bulk of the effort. Thus, EarthScope EON can provide customized services that engage culturally, economically and geographically diverse audiences at the national and local scales. The EarthScope facilities and research community will provide access to data, models, and visualization tools for educational purposes. Partnerships with other national and local science education and outreach programs at colleges, universities, research facilities and professional societies within the EarthScope community as well as relevant programs at museums and parks, state geologic surveys and emergency management agencies, and K-12 schools are critical to EON's success. These partnerships will allow EON to use existing resources, networks and expertise to gear up quickly and efficiently. As EON develops, it will reciprocate by contributing new resources and expertise to the partnerships that help improve public understanding of Earth systems overall and promote effective application of EarthScope discoveries. In this presentation, we will outline major programs and products envisioned for EarthScope, plans for evaluating those programs locally and nationally, and mechanisms for collaborating with existing E&O programs.

Knowledge on Bone Banking among Participants in an Orthopaedic Conference: A Preliminary Survey

Directory of Open Access Journals (Sweden)

Mohd S

2017-07-01

Full Text Available Despite increasing use of bone graft in Malaysia, there was still lack of data to quantify knowledge level on bone banking among orthopaedic community who are involved in transplantation related work. Therefore, a survey on awareness in tissue banking specifically bone banking, usage and choice of bone grafts was conducted. From 80 respondents, 82.5% were aware about tissue banking however only 12.5% knew of the existence of tissue banks in Malaysia. Femoral head was the bone allograft most often used as a substitute to autograft. Only 34.8% respondents preferred irradiated bone grafts whilst 46.9% preferred nonirradiated, indicating the need to educate the importance of radiation for sterilising tissues. Exhibition was the most preferred medium for awareness programme to disseminate information about bone banking in the orthopaedic community. The professional awareness is necessary to increase the knowledge on the use of bone graft, hence to increase bone transplantation for musculoskeletal surgeries in the country.

The impact of ice-skating injuries on orthopaedic admissions in a regional hospital.

LENUS (Irish Health Repository)